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General NPI Number Information
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NPI Number | 1770932824
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Entity Type | Organization
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Legal Business Name | NATALIE M. STANLEY, DMD & ASSOCIATES, PC
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Dates
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Enumeration Date | 06/09/2016
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Last Update Date | 06/09/2016
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Provider Practice Location Address
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Address Line | 914 MAIN STREET
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City | SOUTHBRIDGE
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State | MA
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Zip | 01550
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Country | US
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Telephone | 508-765-5985
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Fax |
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Provider Business Mailing Address
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Address Line | 914 MAIN STREET
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City | SOUTHBRIDGE
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State | MA
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Zip | 01550
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Country | US
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Telephone | 508-765-5985
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. NATALIE M. STANLEY
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Credential | DMD
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Telephone | 508-765-5985
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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 | DN1856254
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License Number State | MA
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