Provider Demographics
NPI:1679917421
Name:GEORGE, JASON STOCKETT (DDS)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:STOCKETT
Last Name:GEORGE
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 1:12208 MCDONALD CHAPEL DR
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2256
Mailing Address - Country:US
Mailing Address - Phone:240-308-2516
Mailing Address - Fax:
Practice Address - Street 1:12208 MCDONALD CHAPEL DR
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-2256
Practice Address - Country:US
Practice Address - Phone:240-308-2516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program