Kathleen Marie Stack, RDH, MPH

NPI #1073793675 in Willimantic, Connecticut

Provider Information

NPI Number: 1073793675
Entity Type: Individual
Name: Kathleen Marie Stack, RDH, MPH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dental Hygienist
Credential: RDH, MPH
Enumeration Date: Nov 12, 2007
Last Updated: Nov 12, 2007

Practice Location

Address: 1315 MAIN ST
City: Willimantic
State: Connecticut
ZIP Code: 06226-1948
Phone: (860) 450-7456

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X	Primary

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