Individual
STACY HADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
690 3RD ST STE 200, BELOIT, WI 53511-6214
(608) 299-3316
Mailing address
690 3RD ST STE 200, BELOIT, WI 53511-6214
(608) 299-3316
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
10927-16
WI
Other
Enumeration date
03/19/2014
Last updated
03/19/2014
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