Individual
SIOBHAN MARIE STEPHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD MD
Contact information
Practice address
44 TIMBER LANE, SOUTH BURLINGTON, VT 05403-7282
(802) 860-6725
(802) 864-0277
Mailing address
44 TIMBER LANE, SOUTH BURLINGTON, VT 05403-7282
(802) 860-6725
(802) 864-1511
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0160002093
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102V106
MVP
VT
01
—
49278
BLUE CROSS
VT
05
—
VN2292
—
VT
Enumeration date
07/27/2006
Last updated
07/08/2007
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