Provider Demographics
NPI:1326153321
Name:STETLER & STAMPE DENTAL PARTNERSHIP
Entity Type:Organization
Organization Name:STETLER & STAMPE DENTAL PARTNERSHIP
Other - Org Name:WYLIE DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:STETLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-442-2515
Mailing Address - Street 1:611 W BROWN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-5387
Mailing Address - Country:US
Mailing Address - Phone:972-442-2515
Mailing Address - Fax:972-442-2650
Practice Address - Street 1:611 W BROWN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-5387
Practice Address - Country:US
Practice Address - Phone:972-442-2515
Practice Address - Fax:972-442-2650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX160981223G0001X
TX187871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty