Individual
DR. JOHN CHARLES STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
858 JUPITER DR, MADISON, WI 53718-2946
(608) 222-7511
(608) 222-9900
Mailing address
858 JUPITER DR, MADISON, WI 53718-2946
(608) 222-7511
(608) 222-9900
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5000714
WI
Other
Enumeration date
10/20/2006
Last updated
07/08/2007
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