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General NPI Number Information
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NPI Number | 1053548404
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Entity Type | Individual
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Provider Name | KYLE MATTHEW STEIN D.D.S., F.A.C.S
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Gender | Male
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Dates
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Enumeration Date | 06/12/2009
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Last Update Date | 04/21/2022
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Provider Practice Location Address
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Address Line | 1410 JORDAN ST
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City | NORTH LIBERTY
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State | IA
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Zip | 52317-4778
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Country | US
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Telephone | 319-382-3113
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Fax | 319-373-0023
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Provider Business Mailing Address
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Address Line | 1410 JORDAN ST
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City | NORTH LIBERTY
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State | IA
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Zip | 52317-4778
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Country | US
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Telephone | 319-382-3113
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Fax | 319-373-0023
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 08648
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License Number State | IA
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