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General NPI Number Information
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NPI Number | 1730461559
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Entity Type | Organization
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Legal Business Name | STEPHENVILLE FAMILY DENTISTRY, INC.
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Dates
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Enumeration Date | 09/19/2011
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Last Update Date | 09/19/2011
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Provider Practice Location Address
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Address Line | 2541 NORTHWEST LOOP
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City | STEPHENVILLE
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State | TX
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Zip | 76401
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Country | US
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Telephone | 254-968-4433
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Fax | 254-968-3444
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Provider Business Mailing Address
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Address Line | 2541 NORTHWEST LOOP
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City | STEPHENVILLE
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State | TX
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Zip | 76401-1601
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Country | US
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Telephone | 254-968-4433
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Fax | 254-968-3444
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. DAVID LEE STANPHILL
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Credential | DDS
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Telephone | 254-968-4433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 15875
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License Number State | TX
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