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General NPI Number Information
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NPI Number | 1518696855
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Entity Type | Individual
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Provider Name | STEPHIE THERESA CYRIL DMD
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Gender | Female
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 06/09/2022
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Provider Practice Location Address
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Address Line | 109 44TH AVE E STE 200
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City | BRADENTON
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State | FL
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Zip | 34203-3639
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Country | US
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Telephone | 941-357-1292
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Fax |
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Provider Business Mailing Address
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Address Line | 6011 35TH LN E
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City | ELLENTON
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State | FL
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Zip | 34222-7213
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Country | US
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Telephone | 772-777-0464
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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 | DN26997
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License Number State | FL
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