Provider Demographics
NPI:1467010405
Name:GUERRIER, STEPHANIE SPAIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:SPAIN
Last Name:GUERRIER
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 1:803 CARVED OAK DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5185
Mailing Address - Country:US
Mailing Address - Phone:704-677-3701
Mailing Address - Fax:
Practice Address - Street 1:3415 ROGERS RD
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-3809
Practice Address - Country:US
Practice Address - Phone:919-554-9955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11394122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist