Individual
DR. NATALIE JO STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10155 WASHINGTON AVE, STURTEVANT, WI 53177-1645
(262) 844-3011
Mailing address
11801 W WOODLAND CIR, HALES CORNERS, WI 53130-1075
(414) 732-8628
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1001817
WI
Other
Enumeration date
05/10/2018
Last updated
03/03/2020
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