# G. B. STAHL, DDS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GANNON B. STAHL DDS PC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1487200531
- **Legal business name:** GANNON B. STAHL DDS PC
- **Authorized official:** DR. GANNON STAHL DDS (OWNER)
- **Authorized official phone:** (425) 641-3668

## Contact information

- **Practice address:** 14030 NE 24TH ST, SUITE 100, BELLEVUE, WA 98007
- **Practice address phone:** (425) 641-3668
- **Practice address fax:** (425) 747-7611
- **Mailing address:** 14030 NE 24TH ST, SUITE 100, BELLEVUE, WA 98007
- **Mailing address phone:** (425) 641-3668
- **Mailing address fax:** (425) 747-7611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 08/14/2019
- **Last updated:** 08/14/2019