Provider Demographics
NPI:1275975666
Name:STUETZER, DANIELA (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIELA
Middle Name:
Last Name:STUETZER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:DANIELA
Other - Middle Name:
Other - Last Name:CANACHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:5825 LANDERBROOK DR
Mailing Address - Street 2:#122
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-6532
Mailing Address - Country:US
Mailing Address - Phone:440-461-0327
Mailing Address - Fax:
Practice Address - Street 1:5825 LANDERBROOK DR
Practice Address - Street 2:#122
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-6532
Practice Address - Country:US
Practice Address - Phone:440-461-0327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0245451223G0001X
IL019.029723122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Yes1223G0001XDental ProvidersDentistGeneral Practice