Yandoli, Stacey A

Yandoli, Stacey A is an individual health care provider with primary practice located at 776 Grove Rd , West Deptford NJ 08086. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Yandoli, Stacey A can be contacted via phone (856) 848-2211.

Contact Information

Primary practice address
776 Grove Rd West Deptford NJ 08086
Phone: (856) 848-2211
Fax: (856) 848-8630
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 2254200 New York
Dental Providers / Pediatric Dentistry 1223P0221X 22542 New Jersey

Profile Details

NPI number 1407873466
LBN Legal business name Yandoli, Stacey A
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2006
Last updated Oct 2nd, 2014 - about 10 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 1407873466 NPPES
New Jersey MEDICAID 0109193

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