Healthcare Provider Details

I. General information

NPI: 1760301683
Provider Name (Legal Business Name): TIA ELIZABETH THOMPSON STUTZ DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22808 PA-68
CLARION PA
16214
US

IV. Provider business mailing address

387 BRUIN QUEENSTOWN RD
PARKER PA
16049-1707
US

V. Phone/Fax

Practice location:
  • Phone: 814-223-9968
  • Fax:
Mailing address:
  • Phone: 724-996-2343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS045755
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: