Provider Demographics
NPI:1235762188
Name:STIEHL FAMILY DENTISTRY, LLC
Entity Type:Organization
Organization Name:STIEHL FAMILY DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-252-4466
Mailing Address - Street 1:90F GLENDA TRCE # 338
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-3858
Mailing Address - Country:US
Mailing Address - Phone:770-252-4466
Mailing Address - Fax:770-252-2663
Practice Address - Street 1:55 GLENDA TRCE # 338
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-3887
Practice Address - Country:US
Practice Address - Phone:770-252-4466
Practice Address - Fax:770-252-2663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1700990009OtherNPI 1 NUMBER FOR DR. STIEHL