Provider Demographics
NPI:1215128251
Name:WALKER, STEFANIE S (DMD)
Entity type:Individual
Prefix:DR
First Name:STEFANIE
Middle Name:S
Last Name:WALKER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6508
Mailing Address - Street 2:13065 EAST 17TH AVE
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-0508
Mailing Address - Country:US
Mailing Address - Phone:303-862-9932
Mailing Address - Fax:
Practice Address - Street 1:1635 URSULA ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7402
Practice Address - Country:US
Practice Address - Phone:215-313-3990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9332122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist