Individual
MS. BRANDI LEE STALLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADT
Taxonomy
Speciality
Code
Description
License number
State
125K00000X
Advanced Practice Dental Therapist
Primary
ADT10
MN
126800000X
Dental Assistant
A8742
MN
Other
Enumeration date
02/02/2012
Last updated
08/15/2025
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