Individual
MRS. STACIE ANNE ELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
1130 COFFEE RD STE 9A, MODESTO, CA 95355-4228
(209) 571-7283
(209) 571-7285
Mailing address
1130 COFFEE RD STE 9A, MODESTO, CA 95355-4228
(209) 571-7283
(209) 571-7285
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
29984
CA
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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