Individual
JUSTIN STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
9660 FALLS OF NEUSE RD UNIT 153, RALEIGH, NC 27615
(919) 205-0520
Mailing address
9660 FALLS OF NEUSE RD STE 153, RALEIGH, NC 27615-2473
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13386
NC
Other
Enumeration date
08/30/2021
Last updated
10/31/2024
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