Individual
STACY STROUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24928 LAWTON AVE, LOMA LINDA, CA 92354-3431
(913) 209-8921
Mailing address
24928 LAWTON AVE, LOMA LINDA, CA 92354-3431
(913) 209-8921
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDH 25338
CA
Other
Enumeration date
12/06/2013
Last updated
12/06/2013
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