Provider Demographics
NPI:1609907963
Name:SKOUNTRIANOS, HELENA STACEY (DMD,MS, PLLC)
Entity Type:Individual
Prefix:MS
First Name:HELENA
Middle Name:STACEY
Last Name:SKOUNTRIANOS
Suffix:
Gender:F
Credentials:DMD,MS, PLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9317 113TH ST E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-3876
Mailing Address - Country:US
Mailing Address - Phone:253-845-6784
Mailing Address - Fax:253-845-6787
Practice Address - Street 1:9317 113TH ST E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-3876
Practice Address - Country:US
Practice Address - Phone:253-845-6784
Practice Address - Fax:253-845-6787
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000101971223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics