Individual
LISA J STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
423 S MAIN ST, TIPTON, IN 46072-2038
(765) 675-8745
Mailing address
423 S MAIN ST, TIPTON, IN 46072-2038
(765) 675-8745
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009661
IN
Other
Enumeration date
04/01/2008
Last updated
04/01/2008
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