Provider Demographics
NPI:1164756136
Name:STANCU, LIVIA (DDS)
Entity Type:Individual
Prefix:
First Name:LIVIA
Middle Name:
Last Name:STANCU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9662 EVANS ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-3325
Mailing Address - Country:US
Mailing Address - Phone:267-979-5551
Mailing Address - Fax:
Practice Address - Street 1:2200 MONTROSE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-2530
Practice Address - Country:US
Practice Address - Phone:215-545-4395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0379261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice