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NPI Code Detail

MEDICARE: ANDREW HENRY STANEK D.D.S.

MEDICARE:   ANDREW HENRY STANEK  D.D.S.
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
11223E0200XEndodonticsMD8801MD

General Provider Information

NPI Number : 1710996657
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW HENRY STANEK D.D.S.
Provider Business Mailing Address
First Line : 10632 LITTLE PATUXENT PKWY
Second Line : SUITE 252
City : COLUMBIA
State : MD
Zip : 21044-3273
Country : US
Telephone Number : 410-730-0755
Fax Number : 410-730-3342
Provider Business Practice Location Address
First Line : 10632 LITTLE PATUXENT PKWY
Second Line : SUITE 252
City : COLUMBIA
State : MD
Zip : 21044-3273
Country : US
Telephone Number : 410-730-0755
Fax Number : 410-730-3342
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2006
Last Update Date : 07/08/2007

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Directions to “ ANDREW HENRY STANEK D.D.S.” Practice Location

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