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General NPI Number Information
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NPI Number | 1609065481
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Entity Type | Individual
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Provider Name | MARK J STASI DDS
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Gender | Male
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 5055 S KIPLING PKWY
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City | LITTLETON
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State | CO
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Zip | 80127-7932
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Country | US
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Telephone | 303-933-8464
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Fax | 303-932-0436
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Provider Business Mailing Address
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Address Line | 5055 S KIPLING PKWY
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City | LITTLETON
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State | CO
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Zip | 80127-7932
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Country | US
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Telephone | 303-933-8464
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Fax | 303-932-0436
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 105444
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License Number State | CO
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