Individual
DR. CHARLES GLENN STONE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3100 NEW COPELAND RD, TYLER, TX 75701-7940
(903) 597-2848
Mailing address
3100 NEW COPELAND RD, TYLER, TX 75701-7940
(903) 597-2848
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
19877
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203274001
—
TX
Enumeration date
07/18/2006
Last updated
11/03/2009
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