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General NPI Number Information
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NPI Number | 1013325190
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Entity Type | Individual
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Provider Name | MICHELLE ELIZABETH STELMACH D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 08/01/2014
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Last Update Date | 08/01/2014
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Provider Practice Location Address
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Address Line | 2040 COLISEUM DRIVE FAMILY DENTAL LLC
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City | HAMPTON
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State | VA
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Zip | 23666
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Country | US
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Telephone | 757-262-0020
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Fax |
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Provider Business Mailing Address
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Address Line | 350 N. CLARK ST. 6TH FLOOR DENTAL DREAMS LLC C/O JULIETTE BOYCE
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City | CHICAGO
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State | IL
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Zip | 60654
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401414466
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License Number State | VA
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