Individual
DR. STANLEY EARL HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
307 S MAIN, GALLATIN, MO 64640
(660) 663-2814
(660) 663-2822
Mailing address
PO BOX 156, 307 S MAIN, GALLATIN, MO 64640
(660) 663-2814
(660) 663-2822
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
14168
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10798011
BCBS
KS
Enumeration date
08/25/2006
Last updated
07/08/2007
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