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General NPI Number Information
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NPI Number | 1235651803
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Entity Type | Organization
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Legal Business Name | APPALACHIAN PERIODONTICS
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Dates
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Enumeration Date | 07/14/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 419 TOWN MOUNTAIN RD STE 201
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City | PIKEVILLE
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State | KY
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Zip | 41501-1633
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Country | US
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Telephone | 606-422-9176
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Fax | 606-437-9886
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Provider Business Mailing Address
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Address Line | 419 TOWN MOUNTAIN RD STE 201
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City | PIKEVILLE
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State | KY
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Zip | 41501-1633
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Country | US
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Telephone | 606-422-9176
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Fax | 606-437-9886
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. AARON D.F. STANLEY
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Credential | DMD
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Telephone | 606-422-9176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 9537
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License Number State | KY
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