Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | AS2559877 | VA |
NPI | 1003958026 |
---|---|
Provider Name | Dr. Richard T. Stone |
First Address | Alexandria, VA 22301-1333 |
Second Address | Alexandria, VA 22301-1333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 08/07/2007 |