MEDICARE: BOBBI A STANLEY DDS , PA

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1518125327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOBBI A STANLEY DDS , PA

Provider Business Mailing Address
First Line	:	3731 NW CARY PKWY
Second Line	:	SUITE 201
City	:	CARY
State	:	NC
Zip	:	27513-8436
Country	:	US
Telephone Number	:	919-460-9665
Fax Number	:	919-460-0690

Provider Business Practice Location Address
First Line	:	3731 NW CARY PKWY
Second Line	:	SUITE 201
City	:	CARY
State	:	NC
Zip	:	27513-8436
Country	:	US
Telephone Number	:	919-460-9665
Fax Number	:	919-460-0690

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BOBBI STANLEY
Credential	:	DDS
Telephone Number	:	919-460-9665

Provider Enumeration Date	:	05/29/2008
Last Update Date	:	05/29/2008

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