Provider Demographics
NPI:1366583312
Name:POLASKY, STEVEN ELLIOTT (DDS)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:ELLIOTT
Last Name:POLASKY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7797 GOLF CIRCLE DR
Mailing Address - Street 2:J-312
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-7351
Mailing Address - Country:US
Mailing Address - Phone:954-292-6628
Mailing Address - Fax:
Practice Address - Street 1:7797 GOLF CIRCLE DR
Practice Address - Street 2:J-312
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-7351
Practice Address - Country:US
Practice Address - Phone:954-292-6628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 0013900122300000X
FLDN13900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist