Provider Demographics
NPI:1710171186
Name:LEVINE, STANLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:
Last Name:LEVINE
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 1:7997 VIA VILLAGIO
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33412-3135
Mailing Address - Country:US
Mailing Address - Phone:561-626-3291
Mailing Address - Fax:772-692-1006
Practice Address - Street 1:7997 VIA VILLAGIO
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33412-3135
Practice Address - Country:US
Practice Address - Phone:561-626-3291
Practice Address - Fax:772-692-1006
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN167691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice