Healthcare Provider Details
I. General information
NPI: 1205150927
Provider Name (Legal Business Name): CHRISTIAN E. STEIN D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/24/2010
Last Update Date: 03/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
650 E INDIAN SCHOOL RD
PHOENIX AZ
85012-1839
US
IV. Provider business mailing address
650 E INDIAN SCHOOL RD
PHOENIX AZ
85012-1839
US
V. Phone/Fax
- Phone: 602-222-6424
- Fax: 602-222-6585
- Phone: 602-222-6424
- Fax: 602-222-6585
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | D04957 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: