Provider Demographics
NPI:1366594046
Name:BENDER, STEFAN F (DMD)
Entity type:Individual
Prefix:DR
First Name:STEFAN
Middle Name:F
Last Name:BENDER
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 1:1320 SYLVAN RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-7111
Mailing Address - Country:US
Mailing Address - Phone:717-898-3508
Mailing Address - Fax:
Practice Address - Street 1:313 PRIMROSE LN
Practice Address - Street 2:SUITE A
Practice Address - City:MOUNTVILLE
Practice Address - State:PA
Practice Address - Zip Code:17554
Practice Address - Country:US
Practice Address - Phone:717-285-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024308L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice