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NPI 1013055466

NPI 1013055466 : DAVID GLENN STOCK D.D.S. : PLANO, TX

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General NPI Number Information
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    NPI Number           |    1013055466
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID GLENN STOCK D.D.S.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/01/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1312 VILLAGE CREEK DR SUITE 1000
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    City                 |    PLANO
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    State                |    TX
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    Zip                  |    75093-4467
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    Country              |    US
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    Telephone            |    972-267-8625
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    Fax                  |    972-267-9844
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Provider Business Mailing Address
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    Address Line         |    1312 VILLAGE CREEK DR SUITE 1000
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    City                 |    PLANO
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    State                |    TX
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    Zip                  |    75093-4467
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    Country              |    US
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    Telephone            |    972-267-8625
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    Fax                  |    972-267-9844
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    16462
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    License Number State |    TX
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