George Andress Stone IV, DMD
Individual provider Active NPI Dentist · Shalimar, FL
NPI 1265769707 · NPPES record last updated Jan 20, 2012
Key facts
- NPI
- 1265769707
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DN18699 (FL)
- Practice address
- 1115 Eglin Pkwy
Shalimar, FL 32579-1228 - Phone
- (850) 651-1125
- Fax
- (850) 651-5887
- NPI assigned
- Nov 4, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN18699 | FL | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN18699 | FL | Yes |
Addresses
Primary practice location
1115 Eglin Pkwy
Shalimar, FL 32579-1228
Mailing address
1115 Eglin Pkwy
Shalimar, FL 32579-1228
Phone (850) 651-1125
Other providers in Shalimar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.