Healthcare Provider Details

I. General information

NPI: 1053399527
Provider Name (Legal Business Name): JOHN S STONE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

634 SW MULVANE ST
TOPEKA KS
66606-1678
US

IV. Provider business mailing address

634 SW MULVANE ST
TOPEKA KS
66606-1678
US

V. Phone/Fax

Practice location:
  • Phone: 785-233-1756
  • Fax: 785-233-1778
Mailing address:
  • Phone: 785-233-1756
  • Fax: 785-233-1778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number4722
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: