Provider Demographics
NPI:1518696855
Name:CYRIL, STEPHIE THERESA (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHIE
Middle Name:THERESA
Last Name:CYRIL
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 1:6011 35TH LN E
Mailing Address - Street 2:
Mailing Address - City:ELLENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34222-7213
Mailing Address - Country:US
Mailing Address - Phone:772-777-0464
Mailing Address - Fax:
Practice Address - Street 1:109 44TH AVE E STE 200
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-3639
Practice Address - Country:US
Practice Address - Phone:941-357-1292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN26997122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist