Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 7271 | KY |
NPI | 1114902939 |
---|---|
Provider Name | Dr. Heather Lynn Stein |
First Address | Kailua, HI 96734-1660 |
Second Address | Pearl Harbor, HI 96860-4479 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 08/07/2007 |