Individual
JESSE ALLEN STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
516 W ARAPAHO RD STE 103, RICHARDSON, TX 75080-4342
(972) 231-5020
Mailing address
PO BOX 124, PLUMTREE, NC 28664
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
32443
TX
1223P0700X
Prosthodontics
Primary
9243
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5919824
—
NC
Enumeration date
08/03/2010
Last updated
01/31/2021
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