Provider Demographics
NPI:1689828618
Name:STOCKTON, TAMARA WEBSTER (DDS)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:WEBSTER
Last Name:STOCKTON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 HAMPTON ST STE 3145
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-1002
Mailing Address - Country:US
Mailing Address - Phone:803-888-1594
Mailing Address - Fax:803-888-1691
Practice Address - Street 1:2000 HAMPTON ST STE 3145
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-1002
Practice Address - Country:US
Practice Address - Phone:803-888-1594
Practice Address - Fax:803-888-1691
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014123911223G0001X
SC45221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice