Individual
DR. STEVEN EDWARD SMULLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
10 SOUTH ST STE 202, RIDGEFIELD, CT 06877-4125
(203) 403-3686
Mailing address
87 BROOKHOLLOW LN, STAMFORD, CT 06902-1014
(617) 230-1152
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
10246
CT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
20571
MA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
231511
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110076671A
—
MA
Enumeration date
11/08/2005
Last updated
03/14/2019
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