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General NPI Number Information
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NPI Number | 1730198409
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Entity Type | Individual
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Provider Name | STACY ANN CHANDLER RDH
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Gender | Female
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 173 WEST MAIN ST
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City | MONONGAHELA
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State | PA
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Zip | 15063
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Country | US
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Telephone | 724-258-4440
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Fax | 724-258-6454
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Provider Business Mailing Address
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Address Line | 2121 GIBSONTON RD
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City | BELLE VERNON
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State | PA
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Zip | 15012
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Country | US
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Telephone | 724-244-2829
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH067857
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License Number State | PA
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