Provider Demographics
NPI:1033129705
Name:STANELL, LAURIE ANNE (DMD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:ANNE
Last Name:STANELL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:LAURIE
Other - Middle Name:ANNE
Other - Last Name:STANELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:4950 YORK RD
Mailing Address - Street 2:PO BOX 708 SUITE 2-H
Mailing Address - City:HOLICONG
Mailing Address - State:PA
Mailing Address - Zip Code:18928-6000
Mailing Address - Country:US
Mailing Address - Phone:215-794-3898
Mailing Address - Fax:215-794-9082
Practice Address - Street 1:4950 YORK RD
Practice Address - Street 2:4950 YORK ROAD SUITE 2-H
Practice Address - City:HOLICONG
Practice Address - State:PA
Practice Address - Zip Code:18928-6000
Practice Address - Country:US
Practice Address - Phone:215-794-3898
Practice Address - Fax:215-794-9082
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
PADS024879L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies