Individual
MAURIELLE STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4401 PENN AVE, PITTSBURGH, PA 15224
(412) 692-5440
Mailing address
4401 PENN AVE, PITTSBURGH, PA 15224
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
16611
PA
Other
Enumeration date
08/07/2014
Last updated
09/07/2016
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