Healthcare Provider Details

I. General information

NPI: 1699974337
Provider Name (Legal Business Name): KARYN LISA STERN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 PARK AVE STE 303
WORCESTER MA
01609-1991
US

IV. Provider business mailing address

255 PARK AVE STE 303
WORCESTER MA
01609-1991
US

V. Phone/Fax

Practice location:
  • Phone: 508-755-3636
  • Fax: 508-791-7245
Mailing address:
  • Phone: 508-755-3636
  • Fax: 508-791-7245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number21853
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: