Provider Demographics
NPI:1205694866
Name:STEPHANIE HUKILL, DDS, PLLC
Entity type:Organization
Organization Name:STEPHANIE HUKILL, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ATLAS
Authorized Official - Last Name:HUKILL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-458-2093
Mailing Address - Street 1:501 ALUCIO CT
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-7952
Mailing Address - Country:US
Mailing Address - Phone:704-458-2093
Mailing Address - Fax:
Practice Address - Street 1:11210 GOLF LINKS DR N
Practice Address - Street 2:SUITE 202
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277
Practice Address - Country:US
Practice Address - Phone:704-343-5998
Practice Address - Fax:704-612-6920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty