Provider Demographics
NPI:1043216070
Name:STEIN, STEPHEN ELLIOT (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ELLIOT
Last Name:STEIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10806 US HIGHWAY 19
Mailing Address - Street 2:STE 101
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-2563
Mailing Address - Country:US
Mailing Address - Phone:727-863-2497
Mailing Address - Fax:727-862-7862
Practice Address - Street 1:10806 US HIGHWAY 19
Practice Address - Street 2:STE 101
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-2563
Practice Address - Country:US
Practice Address - Phone:727-863-2497
Practice Address - Fax:727-862-7862
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 65081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice