Provider Demographics
NPI:1801573530
Name:STOKER, GARRETT (DDS)
Entity type:Individual
Prefix:
First Name:GARRETT
Middle Name:
Last Name:STOKER
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 1:1935 SAND HILL DR
Mailing Address - Street 2:
Mailing Address - City:WEST RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99353-5118
Mailing Address - Country:US
Mailing Address - Phone:509-440-9623
Mailing Address - Fax:
Practice Address - Street 1:2620 S WILLIAMS PL STE 120
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-1867
Practice Address - Country:US
Practice Address - Phone:509-497-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-04
Last Update Date:2023-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61447969122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist