Individual
JENNIFER STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
203 20TH ST NW, WAVERLY, IA 50677-2017
(319) 352-5222
Mailing address
203 20TH ST NW, WAVERLY, IA 50677-2017
(319) 352-5222
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
08511
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0076372
—
IA
Enumeration date
08/01/2007
Last updated
07/07/2008
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