Provider Demographics
NPI:1295001501
Name:JOSEPHINE STOKES, DDS, PC
Entity Type:Organization
Organization Name:JOSEPHINE STOKES, DDS, PC
Other - Org Name:PEARLY WHITES OF EUGENE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:541-686-3003
Mailing Address - Street 1:622 E 22ND AVE STE E
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-2989
Mailing Address - Country:US
Mailing Address - Phone:541-686-3003
Mailing Address - Fax:
Practice Address - Street 1:622 E 22ND AVE STE E
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-2989
Practice Address - Country:US
Practice Address - Phone:541-686-3003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
D81171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty