Individual
STEPHANIE R HOLLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
115 W WALNUT ST, ELLINGTON, MO 63638-9300
(573) 663-3177
(573) 663-3188
Mailing address
PO BOX 157, ELLINGTON, MO 63638-0157
(573) 663-2313
(573) 663-2441
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2017017988
MO
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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