Fletcher-Stark, Madelyn Lucille

Fletcher-Stark, Madelyn Lucille is an individual health care provider with primary practice located at 8521 Golf Course Rd Nw Ste 116 , Albuquerque NM 87114-4549. She recently has only one registered license in Dental Providers / Prosthodontics, which is considered as her primary health care specialty. Fletcher-Stark, Madelyn Lucille can be contacted via phone (505) 897-6453.

Contact Information

Primary practice address
8521 Golf Course Rd Nw Ste 116 Albuquerque NM 87114-4549
Phone: (505) 897-6453
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Prosthodontics 1223P0700X 47259 California
Dental Providers / Prosthodontics 1223P0700X DD4508 New Mexico

Profile Details

NPI number 1528392115
LBN Legal business name Fletcher-Stark, Madelyn Lucille
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2009
Last updated Oct 17th, 2017 - about 9 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 1528392115 NPPES
California Other 47259 LICENSE NUMBER

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