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General NPI Number Information
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NPI Number | 1871268862
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Entity Type | Individual
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Provider Name | STAVROULA ANTONOPOULOU DDS, MS
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Gender | Female
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Dates
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Enumeration Date | 08/11/2021
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Last Update Date | 08/11/2021
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Provider Practice Location Address
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Address Line | 5765 CENTRE AVE APT 326
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City | PITTSBURGH
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State | PA
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Zip | 15206-5706
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Country | US
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Telephone | 469-349-7690
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Fax |
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Provider Business Mailing Address
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Address Line | 5765 CENTRE AVE APT 326
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City | PITTSBURGH
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State | PA
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Zip | 15206-5706
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Country | US
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Telephone | 469-349-7690
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | RFD000045
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License Number State | PA
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