Healthcare Provider Details

I. General information

NPI: 1134285786
Provider Name (Legal Business Name): CHRISTINA ELIZABETH STOEVER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 02/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5975 ROSWELL RD NE SUITE 229
ATLANTA GA
30328-4048
US

IV. Provider business mailing address

5975 ROSWELL RD NE SUITE 229
ATLANTA GA
30328-4048
US

V. Phone/Fax

Practice location:
  • Phone: 404-252-7373
  • Fax: 404-252-7393
Mailing address:
  • Phone: 404-252-7373
  • Fax: 404-252-7393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License NumberDN013001
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: