Provider Demographics
NPI:1215962014
Name:STEIN, STEPHEN T (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:T
Last Name:STEIN
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 1:2600 PARK AVE #104
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-1922
Mailing Address - Country:US
Mailing Address - Phone:925-687-0177
Mailing Address - Fax:925-687-0598
Practice Address - Street 1:2600 PARK AVE STE 104
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1922
Practice Address - Country:US
Practice Address - Phone:925-687-0177
Practice Address - Fax:925-687-0598
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA413131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice