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Individual
STEFANIE ANN REYNOLDS
Active
Individual
STEFANIE ANN REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
58572
CA
1223D0001X
Public Health Dentistry
58572
CA
1223G0001X
General Practice Dentistry
58572
CA
1223P0221X
Pediatric Dentistry
58572
CA
1223P0300X
Periodontics
58572
CA
Other
Enumeration date
09/17/2009
Last updated
12/12/2011
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