Provider Demographics
NPI:1255627303
Name:BARLOW, STEPHANIE F (DDS)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:F
Last Name:BARLOW
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:L
Other - Last Name:FREUDENTHAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:102 BIG PINE DRIVE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433
Mailing Address - Country:US
Mailing Address - Phone:864-641-5511
Mailing Address - Fax:
Practice Address - Street 1:102 FONTAINBLEAU DRIVE
Practice Address - Street 2:SUITE F-2
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471
Practice Address - Country:US
Practice Address - Phone:864-641-5511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0251601223P0221X
LA61881223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty