Healthcare Provider Details

I. General information

NPI: 1083260665
Provider Name (Legal Business Name): STEPHANIE KARIN MUSE RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2019
Last Update Date: 08/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 W SCHUYLKILL RD
POTTSTOWN PA
19465-7438
US

IV. Provider business mailing address

1500 STRATFORD CT
POTTSTOWN PA
19465-7279
US

V. Phone/Fax

Practice location:
  • Phone: 610-326-9460
  • Fax:
Mailing address:
  • Phone: 484-529-4331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH071320
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: