| NPI | 1255627303 |
|---|---|
| Former Name | STEPHANIE L FREUDENTHAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 6188) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.025160) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2019-04-25 |