Provider Demographics
NPI:1639609605
Name:STANCATO, EMILY A (DDS)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:A
Last Name:STANCATO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:A
Other - Last Name:POHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1680 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:UNION GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53182-1525
Mailing Address - Country:US
Mailing Address - Phone:262-878-1500
Mailing Address - Fax:
Practice Address - Street 1:1680 15TH AVE
Practice Address - Street 2:
Practice Address - City:UNION GROVE
Practice Address - State:WI
Practice Address - Zip Code:53182-1525
Practice Address - Country:US
Practice Address - Phone:262-878-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WI1001649-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program