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Provider Information for 1962422758



MARTIN E STOCKER DDS

Gender: MALE

Individual NPI: 1962422758

Calendar Last Updated: 2007-07-08

Details

Name Value
NPI 1962422758
Enumeration Date 2006-07-21
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 1721 W 35TH ST A
AUSTIN, TX 78703-1320
United States

Phone: 512-476-1922 | Fax:
View Map External Link
Primary Practice Address 1721 W 35TH ST A
AUSTIN, TX 78703-1320
United States

Phone: 512-476-1922 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice TX 19148