Individual
DR. CARL ELDEN STUBBLEFIELD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8033 W 159TH ST, OVERLAND PARK, KS 66223-2914
(913) 215-9664
Mailing address
8033 W 159TH ST, OVERLAND PARK, KS 66223-2914
(913) 215-9664
(913) 215-9664
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
62091
KS
122300000X
Dentist
D3838
ID
1223G0001X
General Practice Dentistry
D-3838
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BC6K869
BCBS
ID
Enumeration date
01/09/2007
Last updated
05/16/2024
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