Provider Demographics
NPI:1699925719
Name:STEPHENS, ANNA CORNELIA (DMD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:CORNELIA
Last Name:STEPHENS
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 1:7 MCDOWELL ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4116
Mailing Address - Country:US
Mailing Address - Phone:828-252-4290
Mailing Address - Fax:
Practice Address - Street 1:7 MCDOWELL ST
Practice Address - Street 2:SUITE 110
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4116
Practice Address - Country:US
Practice Address - Phone:828-252-4290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4096122300000X
SCFP07844781223G0001X
NC9265122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice