Individual
GARY EDWARD STOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
112 CLUB COURSE DR, HILTON HEAD ISLAND, SC 29928-3130
(706) 768-1893
Mailing address
112 CLUB COURSE DRIVE, HILTON HEAD ISLAND, SC 29928
(706) 768-1893
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN008968
GA
1223G0001X
General Practice Dentistry
Primary
DN008968
GA
Other
Enumeration date
01/30/2015
Last updated
01/30/2015
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