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Individual

DR. STEPHANIE LYNN HAWLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
1491 E 10TH ST, ROLLA, MO 65401-3996
(573) 364-2868
Mailing address
1491 E 10TH ST, ROLLA, MO 65401-3996

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
041854
PA
1223G0001X
General Practice Dentistry
Primary
2022021327
MO
1223G0001X
General Practice Dentistry
61538
KS

Other

Enumeration date
07/24/2018
Last updated
08/12/2024
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