Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 04389 | NH |
NPI | 1063502516 |
---|---|
Provider Name | Dr. Kyle R Stiefel |
First Address | Plaistow, NH 03865-2843 |
Second Address | Plaistow, NH 03865-2843 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 13/08/2020 |