Doctor Name: | VANESA T STILLMAN |
NPI Number: | 1306806500 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.M.D |
License Number: | DN16130 |
Business Practice Address: | 4151 Day Bridge Pl Ellenton, FL - 342227236 |
Business Phone Number: | 9415276284 |
Business Fax Number: | 9415180917 |
Mailing Address: | 4151 Day Bridge Pl, ELLENTON |
State: | FL |
Postal Code: | 342227236 |
Phone Number: | 9415276284 |
Fax Number: | 9415180917 |
NPI Enumeration Date: | 03/23/2006 |
NPI Last Update Date: | 08/14/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | DN16130 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |