| NPI | 1649525213 |
|---|---|
| Former Name | STEPHANIE MARIE STUCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30-24892) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019029173) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2018-04-16 |