Individual
CONSTANCE SUZANNE STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HYGIENIST
Contact information
Practice address
2960 TONGASS AVE, SUITE 403, KETCHIKAN, AK 99901-5742
(907) 228-4902
(907) 228-5256
Mailing address
2960 TONGASS AVE, SUITE 403, KETCHIKAN, AK 99901-5742
(907) 228-4902
(907) 228-5256
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
493
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174
HYGIENIST LICENSED TO ADM
AK
01
—
493
DENTAL HYGIENE LICENSE
AK
Enumeration date
03/09/2007
Last updated
07/08/2007
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