Provider Demographics
NPI:1467558742
Name:STAFFORD, GARY DUANE (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:DUANE
Last Name:STAFFORD
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:3037 HOPYARD RD
Mailing Address - Street 2:#I
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-5255
Mailing Address - Country:US
Mailing Address - Phone:925-485-1544
Mailing Address - Fax:925-485-1558
Practice Address - Street 1:3037 HOPYARD RD
Practice Address - Street 2:#I
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-5255
Practice Address - Country:US
Practice Address - Phone:925-485-1544
Practice Address - Fax:925-485-1558
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA356551223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics