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General NPI Number Information
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NPI Number | 1568973089
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Entity Type | Organization
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Legal Business Name | TODD T. STANSBERRY, D.D.S. , PLLC
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Dates
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Enumeration Date | 10/24/2017
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Last Update Date | 10/24/2017
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Provider Practice Location Address
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Address Line | 5501 INDEPENDENCE PKWY STE 200
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City | PLANO
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State | TX
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Zip | 75023-5445
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Country | US
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Telephone | 972-867-8882
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Fax | 972-867-9321
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Provider Business Mailing Address
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Address Line | 5501 INDEPENDENCE PKWY STE 200
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City | PLANO
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State | TX
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Zip | 75023-5445
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Country | US
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Telephone | 972-867-8882
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Fax | 972-867-9321
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISS DONNA M CARUSO
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Credential |
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Telephone | 972-867-8882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 24177
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License Number State | TX
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