Healthcare Provider Details

I. General information

NPI: 1811977820
Provider Name (Legal Business Name): JOSEPH STOLL DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 02/17/2021
Certification Date: 02/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10345 PARKGLENN WAY SUITE 200
PARKER CO
80138
US

IV. Provider business mailing address

10345 PARKGLENN WAY SUITE 200
PARKER CO
80138
US

V. Phone/Fax

Practice location:
  • Phone: 520-271-0336
  • Fax:
Mailing address:
  • Phone: 520-271-0336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number10626
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10626
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: