Provider Demographics
NPI:1962666024
Name:STEHLI-CLOUSER, ANNE COMFORT (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:COMFORT
Last Name:STEHLI-CLOUSER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ANNE
Other - Middle Name:COMFORT
Other - Last Name:CLOUSER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:117 SOUTH STREET SUITE 209
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-9001
Mailing Address - Country:US
Mailing Address - Phone:440-286-9551
Mailing Address - Fax:440-286-9656
Practice Address - Street 1:117 SOUTH ST
Practice Address - Street 2:SUITE 209
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-1340
Practice Address - Country:US
Practice Address - Phone:440-286-9551
Practice Address - Fax:440-286-9656
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH17890122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist