Organization
JEFFREY J STASCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY J STASCH DDS (OWNER)
(620) 275-4782
Entity
Organization
Contact information
Practice address
1812 E MARY ST, GARDEN CITY, KS 67846-3652
(620) 275-4782
Mailing address
1812 E MARY ST, GARDEN CITY, KS 67846
(602) 275-4782
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
6077
KS
Other
Enumeration date
02/16/2017
Last updated
02/16/2017
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