Provider Demographics
NPI:1346310133
Name:DOTY, STAN KEVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STAN
Middle Name:KEVIN
Last Name:DOTY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:STAN
Other - Middle Name:K
Other - Last Name:DOTY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:811 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840
Mailing Address - Country:US
Mailing Address - Phone:419-423-1534
Mailing Address - Fax:419-423-3134
Practice Address - Street 1:811 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840
Practice Address - Country:US
Practice Address - Phone:419-423-1534
Practice Address - Fax:419-423-3134
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300164121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice