Individual
JAMES T STORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
4090 WESTOWN PKWY STE 101, WEST DES MOINES, IA 50266-6760
(515) 225-4310
(866) 259-5317
Mailing address
4090 WESTOWN PKWY STE 101, WEST DES MOINES, IA 50266-6760
(515) 225-4310
(866) 259-5317
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
08892
IA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
2011016146
MO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D12580
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
Enumeration date
07/14/2008
Last updated
07/30/2012
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