Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 30.025210 | OH |
NPI | 1083005540 |
---|---|
Provider Name | Dr. Daisy N Stojanov |
First Address | Beachwood, OH 44122 |
Second Address | Beachwood, OH 44122-5928 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2015 |
Last Update Date | 18/09/2018 |