Individual
CHLOE ANN STUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1081 E 18TH ST, ROLLA, MO 65401-2448
(573) 426-6712
(573) 426-6735
Mailing address
1081 E 18TH ST, ROLLA, MO 65401-2448
(573) 426-6712
(573) 426-6735
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
2017017370
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801325121
—
MO
Enumeration date
06/08/2017
Last updated
07/21/2022
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