Provider Demographics
NPI:1326041310
Name:KLEIN, MICHAEL STUART (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STUART
Last Name:KLEIN
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 1:305 E 55TH ST
Mailing Address - Street 2:APT 101
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4148
Mailing Address - Country:US
Mailing Address - Phone:212-752-2222
Mailing Address - Fax:212-752-2223
Practice Address - Street 1:305 E 55TH ST
Practice Address - Street 2:APT 101
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4148
Practice Address - Country:US
Practice Address - Phone:212-752-2222
Practice Address - Fax:212-752-2223
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY270051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice