Individual
STEPHEN THADDEUS CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,D.D.S.
Contact information
Practice address
4150 CLEMENT ST, SAN FRANCISCO, CA 94121-1545
(415) 476-8999
Mailing address
1320 TUOLUMNE RD, MILLBRAE, CA 94030-1536
(415) 385-0665
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
A95042
CA
Other
Enumeration date
04/10/2007
Last updated
04/18/2012
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