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General NPI Number Information
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NPI Number | 1790166510
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Entity Type | Organization
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Legal Business Name | STACEY C. LAYMAN DDS PLLC
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Dates
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Enumeration Date | 06/17/2015
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Last Update Date | 06/17/2015
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Provider Practice Location Address
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Address Line | 7200 W BELL RD SUITE C3
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City | GLENDALE
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State | AZ
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Zip | 85308-8529
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Country | US
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Telephone | 623-979-1900
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Fax | 623-979-4913
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Provider Business Mailing Address
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Address Line | 7200 W BELL RD SUITE C3
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City | GLENDALE
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State | AZ
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Zip | 85308-8529
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Country | US
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Telephone | 623-979-1900
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Fax | 623-979-4913
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Authorized Official
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Title or Position | OWNER
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Name | DR. STACEY C LAYMAN
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Credential | DDS
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Telephone | 623-979-1900
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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 | D5894
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License Number State | AZ
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