Individual
DR. WILLIE L STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
16291
MA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN16291
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
726209
TUFTS HEALTH PLAN
MA
01
—
X04651
BCBS MA
MA
Enumeration date
07/28/2006
Last updated
09/28/2011
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