Individual
STEPHANIE DYANE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
7223 MISSISSIPPI AVE, FORT POLK, LA 71459
(337) 531-4762
Mailing address
131 GAY VILLAGE RD, NATCHITOCHES, LA 71457-7145
(480) 217-0680
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN.00203702
CO
Other
Enumeration date
07/30/2018
Last updated
07/30/2018
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