Stanley Chris Gay, DMD
Individual provider Active NPI Public Health Dentistry · Hardwick, GA
NPI 1417548827 · NPPES record last updated Jan 28, 2021
Key facts
- NPI
- 1417548827
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Public Health Dentistry 1223D0001X
- License
- DN010545 (GA)
- Practice address
- Baldwin State Prison
Hardwick, GA 31034 - Phone
- (478) 445-6174
- NPI assigned
- Jan 28, 2021
- 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 |
|---|---|---|---|
| DN010545 | GA | MD | Public Health Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | DN010545 | GA | Yes |
Addresses
Primary practice location
Baldwin State Prison
Hardwick, GA 31034
Mailing address
3088 Plantation Dr
Dublin, GA 31021-3281
Phone (478) 274-0286
Other providers in Hardwick, GA
All providers in Hardwick, GA · Public Health Dentistry in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2021. 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.