MEDICARE: DR. PETER A. STONE 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	15899	CA

General Provider Information

NPI Number	:	1942370606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER A. STONE DDS

Provider Business Mailing Address
First Line	:	925 W 34TH ST
Second Line	:	ROOM #151
City	:	LOS ANGELES
State	:	CA
Zip	:	90089-0641
Country	:	US
Telephone Number	:	213-740-7405
Fax Number	:	213-740-4813

Provider Business Practice Location Address
First Line	:	925 W 34TH ST
Second Line	:	ROOM #151
City	:	LOS ANGELES
State	:	CA
Zip	:	90089-0641
Country	:	US
Telephone Number	:	213-740-7405
Fax Number	:	213-740-4813

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

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	07/08/2007

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