Provider Demographics
NPI:1093930034
Name:STEIN, GARY M (DDS,PA)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:M
Last Name:STEIN
Suffix:
Gender:M
Credentials:DDS,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8150 ROYAL PALM BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5704
Mailing Address - Country:US
Mailing Address - Phone:954-755-8003
Mailing Address - Fax:954-755-9482
Practice Address - Street 1:8150 ROYAL PALM BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5704
Practice Address - Country:US
Practice Address - Phone:954-755-8003
Practice Address - Fax:954-755-9482
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL661181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice