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General NPI Number Information
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NPI Number | 1083005540
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Entity Type | Individual
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Provider Name | DAISY N STOJANOV BDS, MSD
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Gender | Female
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Dates
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Enumeration Date | 02/05/2015
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 23250 MERCANTILE RD STE 110N
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City | BEACHWOOD
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State | OH
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Zip | 44122-5928
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Country | US
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Telephone | 216-577-0319
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Fax |
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Provider Business Mailing Address
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Address Line | 23250 MERCANTILE RD, SUITE 110N
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City | BEACHWOOD
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State | OH
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Zip | 44122
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | RES3522
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 30.025210
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License Number State | OH
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