MEDICARE: DR. MICHAEL SCOTT STOKES DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	35657	CA

General Provider Information

NPI Number	:	1578569943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL SCOTT STOKES DDS

Provider Business Mailing Address
First Line	:	1310 TARA HILLS DR
Second Line	:	STE F
City	:	PINOLE
State	:	CA
Zip	:	94564-2533
Country	:	US
Telephone Number	:	510-724-6900
Fax Number	:	510-724-2707

Provider Business Practice Location Address
First Line	:	1310 TARA HILLS DR
Second Line	:	STE F
City	:	PINOLE
State	:	CA
Zip	:	94564-2533
Country	:	US
Telephone Number	:	510-724-6900
Fax Number	:	510-724-2707

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	10/29/2008

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