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General NPI Number Information
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NPI Number | 1609441120
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Entity Type | Organization
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Legal Business Name | CENTRAL DENTAL SPECIALISTS, P.C.
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Dates
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Enumeration Date | 05/26/2021
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 114 CENTRAL ST
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City | STONEHAM
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State | MA
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Zip | 02180-1207
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Country | US
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Telephone | 781-438-6618
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Fax |
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Provider Business Mailing Address
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Address Line | 114 CENTRAL ST
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City | STONEHAM
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State | MA
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Zip | 02180-1207
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Country | US
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Telephone | 781-438-6618
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL STANGLER DAVID STANGLER
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Credential | DDS, MDS
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Telephone | 763-221-5190
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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