Provider Demographics
NPI:1164507042
Name:STAMLER, MENACHEM I (DMD)
Entity Type:Individual
Prefix:DR
First Name:MENACHEM
Middle Name:I
Last Name:STAMLER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 STATE ST
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-4421
Mailing Address - Country:US
Mailing Address - Phone:201-487-1140
Mailing Address - Fax:201-487-4418
Practice Address - Street 1:405 STATE ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-4421
Practice Address - Country:US
Practice Address - Phone:201-487-1140
Practice Address - Fax:201-487-4418
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ109201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice