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General NPI Number Information
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NPI Number | 1730821794
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Entity Type | Organization
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Legal Business Name | BROOKE S STILES DMD II PLLC
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Dates
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Enumeration Date | 04/11/2022
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Last Update Date | 04/11/2022
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Provider Practice Location Address
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Address Line | 20 OFFICE PARK DR
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City | JACKSONVILLE
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State | NC
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Zip | 28546-7325
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Country | US
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Telephone | 910-353-3551
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Fax |
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Provider Business Mailing Address
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Address Line | 20 OFFICE PARK DR
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City | JACKSONVILLE
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State | NC
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Zip | 28546-7325
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Country | US
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Telephone | 910-353-3551
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. BROOKE S STILES
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Credential | D.M.D.
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Telephone | 910-612-3652
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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 |
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License Number State |
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