Provider Demographics
NPI:1538291570
Name:STANGE, FREDERICK ARTHUR III (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:ARTHUR
Last Name:STANGE
Suffix:III
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 1:210 E 47TH ST
Mailing Address - Street 2:APARTTMENT 1D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-2108
Mailing Address - Country:US
Mailing Address - Phone:212-888-3570
Mailing Address - Fax:
Practice Address - Street 1:210 E 47TH ST
Practice Address - Street 2:APARTTMENT 1D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-2108
Practice Address - Country:US
Practice Address - Phone:212-888-3570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0501441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice