Individual
DR. CASSANDRA LYNNE STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
2130 CLIFF RD STE 100, EAGAN, MN 55122-2486
(651) 452-6933
Mailing address
2130 CLIFF RD STE 100, EAGAN, MN 55122-2486
(651) 452-6933
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D12052
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116645000
—
MN
Enumeration date
03/27/2006
Last updated
11/06/2024
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