| NPI | 1588959811 |
|---|---|
| Former Name | STEPHANIE CHAMBERS FURLONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NC 9123) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 9123) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2022-08-24 |