Individual
DR. JOEL STITES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
103 W CRANFORD AVE, VALDOSTA, GA 31602-2930
(229) 249-0717
Mailing address
103 W CRANFORD AVE, VALDOSTA, GA 31602-2930
(229) 249-0717
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012826
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
531785619A
—
GA
Enumeration date
12/08/2006
Last updated
07/08/2007
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