MEDICARE: DR. STELLA MARIE LIONG D.D.S.

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
1	1223G0001X	General Practice Dentistry	0401410535	VA

General Provider Information

NPI Number	:	1699925164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STELLA MARIE LIONG D.D.S.

Provider Business Mailing Address
First Line	:	4 ROBIN LN.
Second Line	:
City	:	FLINT HILL
State	:	VA
Zip	:	22627
Country	:	US
Telephone Number	:	540-675-1188
Fax Number	:	866-261-4150

Provider Business Practice Location Address
First Line	:	4 ROBIN LN.
Second Line	:
City	:	FLINT HILL
State	:	VA
Zip	:	22627
Country	:	US
Telephone Number	:	540-675-1188
Fax Number	:	866-261-4150

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2008
Last Update Date	:	10/30/2008

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