Provider Demographics
NPI:1649925942
Name:STOLLEY, MARGARET ALICE (RDH)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ALICE
Last Name:STOLLEY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 E PATTISON ST
Mailing Address - Street 2:
Mailing Address - City:ELY
Mailing Address - State:MN
Mailing Address - Zip Code:55731-1537
Mailing Address - Country:US
Mailing Address - Phone:160-350-2226
Mailing Address - Fax:
Practice Address - Street 1:345 E PATTISON ST
Practice Address - Street 2:
Practice Address - City:ELY
Practice Address - State:MN
Practice Address - Zip Code:55731-1537
Practice Address - Country:US
Practice Address - Phone:603-502-2268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNH3222124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty