Individual
DR. KOREY B STILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
80 B VETERANS BLVD., ACOMA, NM 87034
(505) 552-5300
Mailing address
PO BOX 130, SAN FIDEL, NM 87049-0130
(505) 552-5300
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2017029561
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H3451
—
NM
Enumeration date
09/28/2017
Last updated
11/06/2017
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