Provider Demographics
NPI:1063502516
Name:STIEFEL, KYLE R (DDS)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:R
Last Name:STIEFEL
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 1:166 PLAISTOW RD UNIT 3
Mailing Address - Street 2:
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865-2843
Mailing Address - Country:US
Mailing Address - Phone:603-257-7080
Mailing Address - Fax:603-836-4560
Practice Address - Street 1:166 PLAISTOW RD UNIT 3
Practice Address - Street 2:
Practice Address - City:PLAISTOW
Practice Address - State:NH
Practice Address - Zip Code:03865-2843
Practice Address - Country:US
Practice Address - Phone:603-257-7080
Practice Address - Fax:603-836-4560
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH043891223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty