Healthcare Provider Details

I. General information

NPI: 1992087365
Provider Name (Legal Business Name): STEPHANIE ANN ADKINS D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE ANN BYARD D.D.S.

II. Dates (important events)

Enumeration Date: 09/12/2011
Last Update Date: 02/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 ROCK SPRINGS RD
CONOWINGO MD
21918-1352
US

IV. Provider business mailing address

49 ROCK SPRINGS RD
CONOWINGO MD
21918-1352
US

V. Phone/Fax

Practice location:
  • Phone: 410-378-9696
  • Fax: 410-378-0787
Mailing address:
  • Phone: 410-378-9696
  • Fax: 410-378-0787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number14542
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS038360
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: