Provider Demographics
NPI:1316594120
Name:STONE SURGICAL ARTS PLLC
Entity Type:Organization
Organization Name:STONE SURGICAL ARTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:
Authorized Official - First Name:MONA
Authorized Official - Middle Name:
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-918-3666
Mailing Address - Street 1:72 ANDORRA DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WESTLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76262-7710
Mailing Address - Country:US
Mailing Address - Phone:817-918-3666
Mailing Address - Fax:
Practice Address - Street 1:72 ANDORRA DRIVE
Practice Address - Street 2:SUITE 110
Practice Address - City:WESTLAKE
Practice Address - State:TX
Practice Address - Zip Code:76262
Practice Address - Country:US
Practice Address - Phone:817-918-3666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-26
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty