Provider Demographics
NPI:1225249493
Name:STEWART, NA'TOYIA SHANAY
Entity Type:Individual
Prefix:MS
First Name:NA'TOYIA
Middle Name:SHANAY
Last Name:STEWART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 11TH ST SE
Mailing Address - Street 2:
Mailing Address - City:GORDO
Mailing Address - State:AL
Mailing Address - Zip Code:35466-2413
Mailing Address - Country:US
Mailing Address - Phone:205-364-0280
Mailing Address - Fax:
Practice Address - Street 1:327 11TH ST SE
Practice Address - Street 2:
Practice Address - City:GORDO
Practice Address - State:AL
Practice Address - Zip Code:35466-2413
Practice Address - Country:US
Practice Address - Phone:205-364-0280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALCERTIFICATE RECEIVED126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant