Individual
STEPHANIE A AVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1166 SW MAIN BLVD, LAKE CITY, FL 32025-5780
(386) 752-7373
(386) 487-1265
Mailing address
1166 SW MAIN BLVD, LAKE CITY, FL 32025-5780
(867) 527-3733
(386) 487-1265
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH12491
FL
Other
Enumeration date
12/04/2020
Last updated
12/04/2020
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