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General NPI Number Information
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NPI Number | 1134513518
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Entity Type | Organization
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Legal Business Name | STEPHEN E. KINERET, DDS, MS, INC
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Dates
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Enumeration Date | 03/24/2015
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 6819 LONETREE BLVD STE 104
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City | ROCKLIN
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State | CA
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Zip | 95765-5877
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Country | US
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Telephone | 916-772-5832
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Fax | 916-772-7586
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Provider Business Mailing Address
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Address Line | 6819 LONETREE BLVD STE 104
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City | ROCKLIN
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State | CA
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Zip | 95765-5877
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Country | US
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Telephone | 916-772-5832
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Fax | 916-772-7586
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHEN ELAN KINERET
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Credential | DDS, MS
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Telephone | 916-772-5832
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 25769
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License Number State | CA
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