Individual
STACY DAWN GREENLAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
1845 HOLSONBACK DR, DAYTONA BEACH, FL 32117-5114
(386) 274-0895
Mailing address
1072 BLOOMSBURY RUN, LAKE MARY, FL 32746-1974
(603) 490-9023
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH22124
FL
Other
Enumeration date
10/05/2016
Last updated
10/05/2016
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