Provider Demographics
NPI:1356510770
Name:FOXMAN, STANLEY BERLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:BERLE
Last Name:FOXMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 RANDOLPH RD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:ROCKVILL
Mailing Address - State:MD
Mailing Address - Zip Code:20852
Mailing Address - Country:US
Mailing Address - Phone:301-770-5353
Mailing Address - Fax:301-770-3829
Practice Address - Street 1:4701 RANDOLPH RD
Practice Address - Street 2:SUITE 114
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852
Practice Address - Country:US
Practice Address - Phone:301-770-5353
Practice Address - Fax:301-770-3829
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3903122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist