Individual
DR. THOMAS N STALL SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1100 VILLAGE HARBOR DR., LAKE WYLIE, SC 29710
(803) 831-8856
(803) 831-8966
Mailing address
1100 VILLAGE HARBOR DR., LAKE WYLIE, SC 29710
(803) 831-8856
(803) 831-8966
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2830
SC
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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