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Individual

JAY R STUCKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
3005 SIERRA PKWY, HUTCHINSON, KS 67502-2972
(620) 663-9119
(620) 663-2225
Mailing address
3005 SIERRA PKWY, HUTCHINSON, KS 67502-2972
(620) 663-9119
(620) 663-2225

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6855
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17393
BCBS PVDR NUMBER
KS
Enumeration date
09/07/2006
Last updated
07/08/2007
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