MEDICARE: DR. KILIAN MICHAEL STINGLE DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN26118	FL

General Provider Information

NPI Number	:	1285204305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KILIAN MICHAEL STINGLE DMD

Provider Business Mailing Address
First Line	:	14350 HAMPSHIRE BAY CIR
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-5905
Country	:	US
Telephone Number	:	407-529-5215
Fax Number	:

Provider Business Practice Location Address
First Line	:	65 W MITCHELL HAMMOCK RD STE 1511
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-6969
Country	:	US
Telephone Number	:	407-604-0399
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2021
Last Update Date	:	06/30/2021

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