Provider Demographics
NPI:1730265802
Name:STEFFAS, THOMAS JOHN (DMD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:JOHN
Last Name:STEFFAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 AVERY RD
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-1650
Mailing Address - Country:US
Mailing Address - Phone:440-526-4866
Mailing Address - Fax:440-526-9204
Practice Address - Street 1:8200 AVERY RD
Practice Address - Street 2:
Practice Address - City:BROADVIEW HTS
Practice Address - State:OH
Practice Address - Zip Code:44147-1650
Practice Address - Country:US
Practice Address - Phone:440-526-4866
Practice Address - Fax:440-526-9204
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300223481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice