NPI | 1316029028 |
---|---|
Doing Business As | STACEY DENTAL |
Entity Type | Organization |
Authorized Contact | JOHN CHARLES STACEY Owner 608-222-7511 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2006-10-20 |
Last Update Date | 2022-07-21 |