MEDICARE: DAVID P. STOCKER D.D.S.

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	DS024328L	PA

General Provider Information

NPI Number	:	1588783294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID P. STOCKER D.D.S.

Provider Business Mailing Address
First Line	:	340 HALLMAN MILL RD
Second Line	:
City	:	PHOENIXVILLE
State	:	PA
Zip	:	19460-1520
Country	:	US
Telephone Number	:	610-495-1606
Fax Number	:	610-873-8312

Provider Business Practice Location Address
First Line	:	110 HOPEWELL RD
Second Line	:	SUITE 1B
City	:	DOWNINGTOWN
State	:	PA
Zip	:	19335-1047
Country	:	US
Telephone Number	:	610-269-8522
Fax Number	:	610-873-8312

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

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	07/08/2007

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