Provider Demographics
NPI:1043563125
Name:STAMLER FAMILY DENTAL LLC
Entity Type:Organization
Organization Name:STAMLER FAMILY DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:STAMLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-838-1177
Mailing Address - Street 1:1375 RTE 23
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-1733
Mailing Address - Country:US
Mailing Address - Phone:973-838-1177
Mailing Address - Fax:
Practice Address - Street 1:1375 RTE 23
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:NJ
Practice Address - Zip Code:07405-1733
Practice Address - Country:US
Practice Address - Phone:973-838-1177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI021903031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty