Provider Demographics
NPI:1073992392
Name:STASNEY, CHRISTY LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:LYNN
Last Name:STASNEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CHRISTY
Other - Middle Name:STASNEY
Other - Last Name:FORSYTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:240 ERLANGER ST
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-3426
Mailing Address - Country:US
Mailing Address - Phone:985-643-4553
Mailing Address - Fax:985-645-0746
Practice Address - Street 1:240 ERLANGER ST
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-3426
Practice Address - Country:US
Practice Address - Phone:985-643-4553
Practice Address - Fax:985-645-0746
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-19
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6556122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist