Individual
DR. GANNON BLAKE STAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
14030 NE 24TH ST STE 100, BELLEVUE, WA 98007-3724
(425) 641-3668
(425) 747-7611
Mailing address
14030 NE 24TH ST STE 100, BELLEVUE, WA 98007-3724
(425) 641-3668
(425) 747-7611
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10985
WA
1223G0001X
General Practice Dentistry
Primary
DE00010985
WA
Other
Enumeration date
09/04/2007
Last updated
08/27/2019
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