Organization
JASON A. STACK, DMD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON ANDREW STACK DMD (PRESIDENT)
(864) 676-0825
Entity
Organization
Contact information
Practice address
40 CREEKVIEW CT, GREENVILLE, SC 29615-4800
(864) 676-0825
(864) 676-9859
Mailing address
40 CREEKVIEW CT, GREENVILLE, SC 29615-4800
(864) 676-0825
(864) 676-9859
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3618
SC
Other
Enumeration date
07/27/2006
Last updated
08/22/2020
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