Healthcare Provider Details

I. General information

NPI: 1073513115
Provider Name (Legal Business Name): STANLEY A MILOBSKY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 FRIENDSHIP BLVD STE 520
CHEVY CHASE MD
20815
US

IV. Provider business mailing address

12004 STARVIEW CT
POTOMAC MD
20854-2858
US

V. Phone/Fax

Practice location:
  • Phone: 301-986-4826
  • Fax: 301-294-3194
Mailing address:
  • Phone: 301-294-0544
  • Fax: 301-294-3194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number2275
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number3804
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: