Individual
KIERSTEN FAITH STANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
951 MAIN ST., LEAKESVILLE, MS 39451
(769) 303-1853
Mailing address
715A DIVISION ST, BILOXI, MS 39530-2209
(228) 374-4991
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
4817-22DH
MS
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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