Provider Demographics
NPI:1689416901
Name:STINSON, KATHERYNE MORGAN (IPDH)
Entity type:Individual
Prefix:
First Name:KATHERYNE
Middle Name:MORGAN
Last Name:STINSON
Suffix:
Gender:F
Credentials:IPDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ROWE STATION RD
Mailing Address - Street 2:
Mailing Address - City:NEW GLOUCESTER
Mailing Address - State:ME
Mailing Address - Zip Code:04260-3820
Mailing Address - Country:US
Mailing Address - Phone:207-441-1989
Mailing Address - Fax:
Practice Address - Street 1:100 ROWE STATION RD
Practice Address - Street 2:
Practice Address - City:NEW GLOUCESTER
Practice Address - State:ME
Practice Address - Zip Code:04260-3820
Practice Address - Country:US
Practice Address - Phone:207-441-1989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist