Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0106X | Oral and Maxillofacial Pathology | 019025212 | IL |
N | 1223P0106X | Oral and Maxillofacial Pathology | 2000174326 | MO |
N | 1223P0221X | Pediatric Dentist | 019025212 | IL |
Y | 1223P0221X | Pediatric Dentist | 2000174326 | MO |
NPI | 1578628418 |
---|---|
Provider Name | Dr. Daniel Charles Stoeckel |
First Address | Saint Louis, MO 63110-1002 |
Second Address | Saint Louis, MO 63110-1002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2006 |
Last Update Date | 05/02/2021 |