Individual
STACIA ANNE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
8066 BOWIE RD, KING GEORGE, VA 22485-7665
(703) 401-1755
Mailing address
8066 BOWIE RD, KING GEORGE, VA 22485-7665
(703) 401-1755
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
0402205910
VA
124Q00000X
Dental Hygienist
Primary
6766
MD
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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