Individual
DR. OLIVIA STALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
5626 PATRIOT DR, WISE, VA 24293-1138
(276) 328-8850
Mailing address
PO BOX 118, COEBURN, VA 24230-0118
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401416861
VA
Other
Enumeration date
06/04/2020
Last updated
06/04/2020
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