MEDICARE: RHONA STANLEY DDS, MPH

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	35318	NY

General Provider Information

NPI Number	:	1902020670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONA STANLEY DDS, MPH

Provider Business Mailing Address
First Line	:	2488 GRAND CONCOURSE
Second Line	:	318
City	:	BRONX
State	:	NY
Zip	:	10458-5203
Country	:	US
Telephone Number	:	718-367-7072
Fax Number	:

Provider Business Practice Location Address
First Line	:	2488 GRAND CONCOURSE
Second Line	:	318
City	:	BRONX
State	:	NY
Zip	:	10458-5203
Country	:	US
Telephone Number	:	718-367-7072
Fax Number	:

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

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	07/08/2007

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