Individual
CAROL STOCKHAUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1301 N EPHRATA AVE, CONNELL, WA 99326-9601
(509) 543-5800
Mailing address
250 GAGE BLVD APT A-2001, RICHLAND, WA 99352-9605
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60679859
WA
Other
Enumeration date
09/19/2016
Last updated
09/19/2016
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