Provider Demographics
NPI:1770072167
Name:VOLTZ, STEFANIE FAYE (MDT)
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:FAYE
Last Name:VOLTZ
Suffix:
Gender:F
Credentials:MDT
Other - Prefix:
Other - First Name:STEFANIE
Other - Middle Name:FAYE
Other - Last Name:VOLTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6452 FAIRWAY DR NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-5943
Mailing Address - Country:US
Mailing Address - Phone:608-393-9593
Mailing Address - Fax:
Practice Address - Street 1:973 SKYLINE DR SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-1220
Practice Address - Country:US
Practice Address - Phone:507-424-1040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-01
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNDT102125J00000X, 125K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes125K00000XDental ProvidersAdvanced Practice Dental Therapist
No125J00000XDental ProvidersDental Therapist