Provider Demographics
NPI:1962453597
Name:PIEDAD, STACY TUNNEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:TUNNEY
Last Name:PIEDAD
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 1:3280 HOWELL MILL RD NW
Mailing Address - Street 2:SUITE 230
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4111
Mailing Address - Country:US
Mailing Address - Phone:404-351-7336
Mailing Address - Fax:
Practice Address - Street 1:3280 HOWELL MILL RD NW
Practice Address - Street 2:SUITE 230
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-4111
Practice Address - Country:US
Practice Address - Phone:404-351-7336
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN013171122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist