Provider Demographics
NPI:1457427726
Name:STEIN, KERRY R (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:KERRY
Middle Name:R
Last Name:STEIN
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 HARDING HWY E
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-4522
Mailing Address - Country:US
Mailing Address - Phone:740-382-4112
Mailing Address - Fax:
Practice Address - Street 1:1515 HARDING HWY E
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-4522
Practice Address - Country:US
Practice Address - Phone:740-382-4112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0215751223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics