Provider Demographics
NPI:1619165974
Name:GUISTWITE, STACY L (RDH)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:L
Last Name:GUISTWITE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:L
Other - Last Name:MERTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:116 S GEORGE ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17401-1474
Mailing Address - Country:US
Mailing Address - Phone:717-846-5846
Mailing Address - Fax:717-854-0377
Practice Address - Street 1:1230 HIGH ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1127
Practice Address - Country:US
Practice Address - Phone:717-632-9052
Practice Address - Fax:717-632-2388
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH011947L124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist