Provider Demographics
NPI:1699272476
Name:SOTILE, STEPHANIE ELISE (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ELISE
Last Name:SOTILE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5012 E BLUEBELL DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-8617
Mailing Address - Country:US
Mailing Address - Phone:225-975-2224
Mailing Address - Fax:
Practice Address - Street 1:4607 SHERWOOD COMMON BLVD BLDG 1
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4892
Practice Address - Country:US
Practice Address - Phone:225-975-2224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA68691223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry