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General NPI Number Information
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NPI Number | 1598910192
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Entity Type | Individual
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Provider Name | STEPHANIE KAY HAMPER DMD
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Gender | Female
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Dates
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Enumeration Date | 11/24/2008
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Last Update Date | 02/08/2013
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Provider Practice Location Address
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Address Line | 203 E SANTA FE AVE
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City | TOLUCA
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State | IL
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Zip | 61369-0674
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Country | US
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Telephone | 815-452-2513
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Fax | 815-452-2585
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Provider Business Mailing Address
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Address Line | 203 E SANTA FE AVE BOX 674
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City | TOLUCA
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State | IL
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Zip | 61369-0674
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Country | US
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Telephone | 815-452-2513
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Fax | 815-452-2585
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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 | 019027768
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License Number State | IL
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