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NPI Code Detail

MEDICARE: TONYA RENEE STEWART DDS

MEDICARE:   TONYA RENEE STEWART  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry12009696AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669581492
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONYA RENEE STEWART DDS
Provider Business Mailing Address
First Line : 7586 TROPHY CLUB DR N
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46214-4051
Country : US
Telephone Number : 317-388-1757
Fax Number :
Provider Business Practice Location Address
First Line : 3838 N RURAL ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-2930
Country : US
Telephone Number : 317-221-2306
Fax Number : 317-221-2336
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2006
Last Update Date : 07/08/2007

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Directions to “ TONYA RENEE STEWART DDS” Practice Location

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