Provider Demographics
NPI:1235155516
Name:STUPPY, GEORGE HUTTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:HUTTON
Last Name:STUPPY
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 1:355 ROUTE #41
Mailing Address - Street 2:PO BOX 156
Mailing Address - City:CHRISTIANA
Mailing Address - State:PA
Mailing Address - Zip Code:17509
Mailing Address - Country:US
Mailing Address - Phone:610-593-2818
Mailing Address - Fax:610-593-5167
Practice Address - Street 1:355 ROUTE #41
Practice Address - Street 2:
Practice Address - City:CHRISTIANA
Practice Address - State:PA
Practice Address - Zip Code:17509
Practice Address - Country:US
Practice Address - Phone:610-593-2818
Practice Address - Fax:610-593-5167
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021015L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice