Individual
STEPHANIE LYNN BROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH, EPPDH
Contact information
Practice address
2157 BROADWAY AVE, NORTH BEND, OR 97459-2329
(503) 880-6816
Mailing address
2157 BROADWAY AVE, NORTH BEND, OR 97459-2329
(503) 880-6816
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H3929
OR
Other
Enumeration date
07/25/2012
Last updated
08/07/2015
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