Stork, James T

Stork, James T is an individual health care provider with primary practice located at 4090 Westown Pkwy Ste 101 , West Des Moines IA 50266-6760. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Stork, James T can be contacted via phone (515) 225-4310.

Contact Information

Primary practice address
4090 Westown Pkwy Ste 101 West Des Moines IA 50266-6760
Phone: (515) 225-4310
Fax: (866) 259-5317
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X D12580 Minnesota
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 08892 Iowa
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 2011016146 Missouri

Profile Details

NPI number 1194989624
LBN Legal business name Stork, James T
Credentials DDS, MS
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2008
Last updated Jul 30th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194989624 NPPES
Minnesota MEDICAID ENROLLED

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