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General NPI Number Information
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NPI Number | 1205854627
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Entity Type | Individual
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Provider Name | STANLEY MARK KAUFMAN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 901 RANCHO LN SUITE 270
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City | LAS VEGAS
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State | NV
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Zip | 89106-3836
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Country | US
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Telephone | 702-636-3060
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Fax | 702-636-3057
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Provider Business Mailing Address
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Address Line | 7917 FANTAIL DR
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89084-2439
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Country | US
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Telephone | 702-399-5956
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4116
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3504
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4993T
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License Number State | NV
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