NPI 1073793675
Kathleen Marie Stack, RDHMPH
Practice location
- Address
- 1315 Main St, Willimantic, CT 06226-1948
- Phone
- (860) 450-7456
- Fax
- (860) 423-4629
- Mailing address
- 84 High St #3, Mystic, CT 06355-2439
Registered specialties
Dental Hygienist
Primary
Registry record
- NPI
- 1073793675
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 12 Nov 2007
- Record last updated
- 12 Nov 2007
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.