Provider Demographics
NPI:1932758992
Name:STONEDENT PLLC
Entity type:Organization
Organization Name:STONEDENT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-855-9652
Mailing Address - Street 1:9116 WOLF CREEK DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-8738
Mailing Address - Country:US
Mailing Address - Phone:254-855-9652
Mailing Address - Fax:
Practice Address - Street 1:581 PAN AMERICAN DR STE 4
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-1960
Practice Address - Country:US
Practice Address - Phone:254-680-5551
Practice Address - Fax:254-754-0907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental