Individual
DR. JOHN W STOCKSTILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1430 JOHN WESLEY GILBERT DRIVE, GC-1024, AUGUSTA, GA 30912-1001
(706) 721-9633
(706) 723-0266
Mailing address
1120 15TH ST, GC-1024, AUGUSTA, GA 30912-0004
(706) 721-9633
(706) 721-0266
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DNF000305
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000942015A
—
GA
05
—
ZG0305
—
SC
Enumeration date
06/08/2006
Last updated
01/26/2012
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