Provider Demographics
NPI:1114350410
Name:BRAWLEY, STANLEY B (DDS)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:B
Last Name:BRAWLEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2654 HORSESHOE CIR
Mailing Address - Street 2:
Mailing Address - City:HUGHES
Mailing Address - State:AR
Mailing Address - Zip Code:72348-9065
Mailing Address - Country:US
Mailing Address - Phone:870-339-2729
Mailing Address - Fax:
Practice Address - Street 1:2654 HORSESHOE CIR
Practice Address - Street 2:
Practice Address - City:HUGHES
Practice Address - State:AR
Practice Address - Zip Code:72348-9065
Practice Address - Country:US
Practice Address - Phone:870-339-2729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-10
Last Update Date:2013-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3811122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist