Provider Demographics
NPI:1043355415
Name:PETER N STAMATIS DDS INC
Entity Type:Organization
Organization Name:PETER N STAMATIS DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:STAMATIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:440-988-4464
Mailing Address - Street 1:355 MILL AVENUE
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-2259
Mailing Address - Country:US
Mailing Address - Phone:440-988-4464
Mailing Address - Fax:440-988-4946
Practice Address - Street 1:355 MILL AVENUE
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-2259
Practice Address - Country:US
Practice Address - Phone:440-988-4464
Practice Address - Fax:440-988-4946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH192711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty