Harry Patrick Stanley, DMD

Individual provider Active NPI Pediatric Dentistry · Decatur, AL

NPI 1639201700 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1639201700
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Dentistry 1223P0221X
License
3719 (AL)
Practice address
1304 14TH Ave SE
Decatur, AL 35601-4315
Phone
(256) 355-0138
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3719ALMDPediatric Dentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 3719 AL Yes

Addresses

Primary practice location

1304 14TH Ave SE
Decatur, AL 35601-4315

Mailing address

1304 14TH Ave SE
Decatur, AL 35601-4315
Phone (256) 355-0138

Other identifiers

IdentifierTypeStateIssuer
510-90132OtherALBCBS OF AL

Other providers in Decatur, AL

All providers in Decatur, AL · Pediatric Dentistry in Alabama

Sources for this page

Verify at the official NPI Registry.