| NPI | 1093821647 |
|---|---|
| Former Name | STEPHANIE LYNN REEDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: FL DN 16425) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: FL DN 16425) |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: FL DN16425) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: FL ME113042) | |
| 208600000X Surgery (Licence: FL ME113042) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2022-10-19 |