Provider Demographics
NPI:1316482243
Name:MERRIFIELD, STEPHANIE (RDH)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:MERRIFIELD
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 S PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:DALLASTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17313-9239
Mailing Address - Country:US
Mailing Address - Phone:717-891-5027
Mailing Address - Fax:
Practice Address - Street 1:745 S PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:DALLASTOWN
Practice Address - State:PA
Practice Address - Zip Code:17313-9239
Practice Address - Country:US
Practice Address - Phone:717-891-5027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-02
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH005710L124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist