Provider Demographics
NPI:1902205420
Name:STONE, VANNA NICOLE (DMD)
Entity Type:Individual
Prefix:DR
First Name:VANNA
Middle Name:NICOLE
Last Name:STONE
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 1:201 S LIVINGSTON AVE STE 2C
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4040
Mailing Address - Country:US
Mailing Address - Phone:973-994-3112
Mailing Address - Fax:
Practice Address - Street 1:201 S LIVINGSTON AVE STE 2C
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4040
Practice Address - Country:US
Practice Address - Phone:973-994-3112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI025813001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice