Individual
MS. NICOLE MARIE STULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DENTAL ASSISTANT
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
22DI02593103
NJ
126800000X
Dental Assistant
Primary
22D102593103
NJ
Other
Enumeration date
08/15/2024
Last updated
11/27/2024
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