Healthcare Provider Details

I. General information

NPI: 1851359715
Provider Name (Legal Business Name): JOY D. STOVCIK D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 SOUTH MAIN ST.
THORNVILLE OH
43076-0265
US

IV. Provider business mailing address

30 SOUTH MAIN STREET P.O. BOX 265
THORNVILLE OH
43076-0265
US

V. Phone/Fax

Practice location:
  • Phone: 740-246-5286
  • Fax: 740-246-5309
Mailing address:
  • Phone: 740-246-5286
  • Fax: 740-246-5309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14525
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: