Individual
DR. STACEY ANN EBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
211 MEMORIAL DR, FORT ATKINSON, WI 53538-1981
(920) 563-2928
Mailing address
211 MEMORIAL DR, FORT ATKINSON, WI 53538-1981
(920) 563-2928
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5909
WI
Other
Enumeration date
12/12/2006
Last updated
01/11/2023
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