Provider Demographics
NPI:1497773352
Name:STUMBO, JAMES WILLIAM (DDS MS INC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WILLIAM
Last Name:STUMBO
Suffix:
Gender:M
Credentials:DDS MS INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 DUDLEY AVE
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-2649
Mailing Address - Country:US
Mailing Address - Phone:304-422-7152
Mailing Address - Fax:304-422-7780
Practice Address - Street 1:2601 DUDLEY AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-2649
Practice Address - Country:US
Practice Address - Phone:304-422-7152
Practice Address - Fax:304-422-7780
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2448122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist