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General NPI Number Information
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NPI Number | 1073658761
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Entity Type | Individual
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Provider Name | ELIZABETH STOCKLEY MUELLER D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9200 MONTGOMERY RD SUITE 4B
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City | MONTGOMERY
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State | OH
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Zip | 45242-7789
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Country | US
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Telephone | 513-791-3660
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Fax |
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Provider Business Mailing Address
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Address Line | 8364 OAKDALE CT
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City | MASON
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State | OH
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Zip | 45040-5009
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Country | US
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Telephone | 513-234-9188
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 017260
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License Number State | OH
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