MEDICARE: ROBERT EVERETT 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	122300000X	Dentist	12006989	IN

General Provider Information

NPI Number	:	1649332537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT EVERETT STOKES DDS

Provider Business Mailing Address
First Line	:	4550 N COLLEGE AVENUE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205
Country	:	US
Telephone Number	:	317-283-4921
Fax Number	:	317-931-0396

Provider Business Practice Location Address
First Line	:	4550 N COLLEGE AVENUE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205
Country	:	US
Telephone Number	:	317-283-4921
Fax Number	:	317-931-0396

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

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	07/08/2007

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