Individual
DR. JACK RYAN STALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
131 INDIAN LAKE RD, SUITE 101, HENDERSONVILLE, TN 37075-3866
(615) 824-1700
(615) 862-2266
Mailing address
131 INDIAN LAKE RD, SUITE101, HENDERSONVILLE, TN 37075-3866
(615) 824-1700
(615) 826-2266
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
9204
TN
Other
Enumeration date
08/27/2007
Last updated
11/29/2010
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