Provider Demographics
NPI:1962422758
Name:STOCKER, MARTIN E (DDS)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:E
Last Name:STOCKER
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 1:1721 W 35TH ST
Mailing Address - Street 2:A
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-1320
Mailing Address - Country:US
Mailing Address - Phone:512-476-1922
Mailing Address - Fax:
Practice Address - Street 1:1721 W 35TH ST
Practice Address - Street 2:A
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-1320
Practice Address - Country:US
Practice Address - Phone:512-476-1922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX191481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice