Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0221X | Pediatric Dentist | DEN03299 | RI |
Y | 1223P0221X | Pediatric Dentist | DN1856799 | MA |
NPI | 1073916284 |
---|---|
Provider Name | Miss Stephanie Altongy |
First Address | Lincoln, RI 02865-1016 |
Second Address | Plainville, MA 02762-2641 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2014 |
Last Update Date | 12/09/2016 |