Provider Demographics
NPI:1174672224
Name:STONE, ANDREW P (DDS)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:P
Last Name:STONE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 JACKSON RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-9220
Mailing Address - Country:US
Mailing Address - Phone:609-654-0241
Mailing Address - Fax:609-654-1209
Practice Address - Street 1:25 JACKSON RD
Practice Address - Street 2:SUITE A
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-9220
Practice Address - Country:US
Practice Address - Phone:609-654-0241
Practice Address - Fax:609-654-1209
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD148341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice