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Individual

DR. SCHADALE STEVENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S

Contact information

Practice address
4813 ROCKBRIDGE RD, STE 26, STONE MOUNTAIN, GA 30083-4200
(404) 292-8383
Mailing address
4813 ROCKBRIDGE RD, STE 26, STONE MOUNTAIN, GA 30083-4200
(404) 292-8383

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
012150
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00909664A
GA
Enumeration date
01/23/2007
Last updated
07/09/2007
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