De Stefano, Mariella

De Stefano, Mariella is an individual health care provider with primary practice located at 12165 Elm St , Princess Anne MD 21853-1358. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. De Stefano, Mariella can be contacted via phone (410) 651-5151.

Contact Information

Primary practice address
12165 Elm St Princess Anne MD 21853-1358
Fax: (410) 651-4256
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X LL777 Maryland

Profile Details

NPI number 1285911222
LBN Legal business name De Stefano, Mariella
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2011
Last updated Oct 18th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285911222 NPPES
Maryland MEDICAID 119591300

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