Provider Demographics
NPI:1881903367
Name:STUMPF, CHRISTINE F (RDH)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:F
Last Name:STUMPF
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 1:2901 W BELTLINE HWY
Mailing Address - Street 2:BOX A
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-4226
Mailing Address - Country:US
Mailing Address - Phone:608-443-5480
Mailing Address - Fax:608-441-1981
Practice Address - Street 1:101 E FOUNTAIN STREET
Practice Address - Street 2:
Practice Address - City:DODGEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53533-1749
Practice Address - Country:US
Practice Address - Phone:608-935-5550
Practice Address - Fax:608-935-5168
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5554-16124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist