Individual
MS. STEFANIE AILEEN TAGGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7525 N CEDAR AVE STE 105, FRESNO, CA 93720-2698
(559) 439-6600
Mailing address
7525 N CEDAR AVE STE 105, FRESNO, CA 93720-2698
(559) 439-6600
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDA82815
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RDA82815
—
CA
Enumeration date
10/21/2021
Last updated
10/21/2021
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