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General NPI Number Information
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NPI Number | 1235427063
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Entity Type | Individual
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Provider Name | KYLE GREGORY STANLEY DDS
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Gender | Male
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Dates
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Enumeration Date | 07/13/2011
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Last Update Date | 10/26/2011
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Provider Practice Location Address
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Address Line | 1000 S HOPE ST APT 221
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City | LOS ANGELES
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State | CA
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Zip | 90015-1492
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Country | US
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Telephone | 714-357-8130
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Fax | 714-777-6734
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Provider Business Mailing Address
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Address Line | 1000 S HOPE ST APT 221
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City | LOS ANGELES
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State | CA
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Zip | 90015-1492
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Country | US
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Telephone | 714-357-8130
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Fax | 714-777-6734
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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 | 59520
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License Number State | CA
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