Individual
DR. KEVIN JOSEPH STOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4390 GREEN ASH DR, EARTH CITY, MO 63045-1219
(314) 537-6815
Mailing address
4390 GREEN ASH DR, EARTH CITY, MO 63045-1219
(314) 537-6815
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2013017372
MO
332B00000X
Durable Medical Equipment & Medical Supplies
2013017372
MO
332BC3200X
Customized Equipment (DME)
2013017372
MO
Other
Enumeration date
08/19/2013
Last updated
09/19/2013
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