Individual
SVETLANA STEFANOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
631 JASON ST NE STE 150, SALEM, OR 97301-2357
(503) 364-3004
Mailing address
4616 HORSESHOE CT SE, SALEM, OR 97317-5593
(503) 510-6712
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H7641
OR
Other
Enumeration date
10/21/2019
Last updated
10/21/2019
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