Healthcare Provider Details

I. General information

NPI: 1235530353
Provider Name (Legal Business Name): STEPHANIE COLLINS FINN D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. STEPHANIE FINN ACZON

II. Dates (important events)

Enumeration Date: 09/08/2014
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 LONGWOOD AVE
BOSTON MA
02115-5819
US

IV. Provider business mailing address

136 ALTER ST
PHILADELPHIA PA
19147-5406
US

V. Phone/Fax

Practice location:
  • Phone: 617-432-1434
  • Fax:
Mailing address:
  • Phone: 518-428-5540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN1856742
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: