Individual
DR. STEPHEN Y FANOUS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
59 BRUNSWICK WOODS DR, EAST BRUNSWICK, NJ 08816-5601
(732) 238-3883
(732) 238-3665
Mailing address
59 BRUNSWICK WOODS DR, EAST BRUNSWICK, NJ 08816-5601
(732) 238-3883
(732) 238-3665
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14091
NJ
Other
Enumeration date
08/09/2005
Last updated
07/08/2007
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