Individual
STACY MICHELLE FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH, LAP
Contact information
Practice address
4583 GRINDE RD, LEWISTOWN, MT 59457-8043
(406) 403-1159
Mailing address
4583 GRINDE RD, LEWISTOWN, MT 59457-8043
(406) 403-1159
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1109
MT
Other
Enumeration date
05/17/2017
Last updated
07/21/2022
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