| D L Stone Dmd Llc | |
|
5771 Vickery St Lavonia GA 30553-1552 | |
| (706) 356-8212 | |
| Not Available |
| Full Name | D L Stone Dmd Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5771 Vickery St, Lavonia, Georgia |
| Authorized Official Name and Position | Dale L Stone (OWNER) |
| Authorized Official Contact | 7063568212 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| D L Stone Dmd Llc 5771 Vickery St Lavonia GA 30553-1552 Ph: (706) 356-8212 | D L Stone Dmd Llc 5771 Vickery St Lavonia GA 30553-1552 Ph: (706) 356-8212 |
| NPI Number | 1881197341 |
|---|---|
| Provider Enumeration Date | 03/12/2018 |
| Last Update Date | 03/12/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881197341 | NPI | - | NPPES |
| 000137849A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 008810 (Georgia) | Primary |