Provider Demographics
NPI:1295097772
Name:HUKILL, STEPHANIE ATLAS (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ATLAS
Last Name:HUKILL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5829 PHYLISS LANE
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227
Mailing Address - Country:US
Mailing Address - Phone:704-790-0590
Mailing Address - Fax:
Practice Address - Street 1:2700 COLTSGATE RD # 204
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-3799
Practice Address - Country:US
Practice Address - Phone:704-749-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019029731122300000X
IL0210025941223P0221X
NC103041223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist