Provider Demographics
NPI:1881683225
Name:ROBERT G. STEIN, D.M.D., PC
Entity Type:Organization
Organization Name:ROBERT G. STEIN, D.M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-532-1630
Mailing Address - Street 1:125 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-5639
Mailing Address - Country:US
Mailing Address - Phone:978-532-1630
Mailing Address - Fax:978-532-5188
Practice Address - Street 1:125 MAIN ST
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-5639
Practice Address - Country:US
Practice Address - Phone:978-532-1630
Practice Address - Fax:978-532-5188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA121581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty