Individual
STACEY A YANDOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
776 GROVE RD, WEST DEPTFORD, NJ 08086
(856) 848-2211
(856) 848-8630
Mailing address
776 GROVE RD, WEST DEPTFORD, NJ 08086
(856) 848-2211
(856) 848-8630
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22542
NJ
1223P0221X
Pediatric Dentistry
2254200
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0109193
—
NJ
Enumeration date
07/16/2006
Last updated
10/02/2014
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