Provider Demographics
NPI:1295007540
Name:STAN WARE, DDS PA
Entity Type:Organization
Organization Name:STAN WARE, DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:WARE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-767-0011
Mailing Address - Street 1:160 ADAM BROWN RD
Mailing Address - Street 2:
Mailing Address - City:PEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:71964-9504
Mailing Address - Country:US
Mailing Address - Phone:501-767-0011
Mailing Address - Fax:501-767-5686
Practice Address - Street 1:160 ADAM BROWN RD
Practice Address - Street 2:
Practice Address - City:PEARCY
Practice Address - State:AR
Practice Address - Zip Code:71964-9504
Practice Address - Country:US
Practice Address - Phone:501-767-0011
Practice Address - Fax:501-767-5686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty