Provider Demographics
NPI:1114571981
Name:DENNIS GARTH STODDARD DDS PLLC
Entity Type:Organization
Organization Name:DENNIS GARTH STODDARD DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:MANCHOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-610-5812
Mailing Address - Street 1:8631 ARBOR CREEK DR STE D3
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-0548
Mailing Address - Country:US
Mailing Address - Phone:704-875-9075
Mailing Address - Fax:
Practice Address - Street 1:8631 ARBOR CREEK DR STE D3
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-0548
Practice Address - Country:US
Practice Address - Phone:704-875-9075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-30
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty