Stack, Kathleen Marie
Stack, Kathleen Marie is an individual health care provider with primary practice located at 1315 Main St , Willimantic CT 06226-1948. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Stack, Kathleen Marie can be contacted via phone (860) 450-7456.Contact Information
Primary practice address
1315 Main St
Willimantic CT 06226-1948
Phone: (860) 450-7456
Fax: (860) 423-4629
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Hygienist | 124Q00000X | 007004 | Connecticut |
Profile Details
| NPI number | 1073793675 |
|---|---|
| LBN Legal business name | Stack, Kathleen Marie |
| Credentials | RDH, MPH |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 12th, 2007 |
| Last updated | Nov 12th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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