Provider Demographics
NPI:1427600238
Name:STANKO, CHLOE G (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHLOE
Middle Name:G
Last Name:STANKO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 LYNCH ST
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-4841
Mailing Address - Country:US
Mailing Address - Phone:508-527-2779
Mailing Address - Fax:
Practice Address - Street 1:389 BROADWAY
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01904-2629
Practice Address - Country:US
Practice Address - Phone:781-595-7953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18583301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice