Stover, Susan I

Stover, Susan I is an individual health care provider with primary practice located at 1367 E Garrison Blvd Ste A, Gastonia NC 28054-5144. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Stover, Susan I can be contacted via phone (704) 864-8393.

Contact Information

Primary practice address
1367 E Garrison Blvd Ste A Gastonia NC 28054-5144
Fax: (704) 864-7312
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 5110 North Carolina

Profile Details

NPI number 1689617029
LBN Legal business name Stover, Susan I
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Jul 8th, 2007 - about 18 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 1689617029 NPPES
Wisconsin Other 561528161016 BCBS OF WI
Wisconsin Other 02929 BCBS OF WI
Wisconsin MEDICAID 8998146 BCBS OF WI
Wisconsin Other 465958 BCBS OF WI

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