Provider Demographics
NPI:1730306697
Name:STANEC, DALE EDWARD JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:EDWARD
Last Name:STANEC
Suffix:JR
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 1:3955 CAMERON PARK DR
Mailing Address - Street 2:
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682-8203
Mailing Address - Country:US
Mailing Address - Phone:530-676-6500
Mailing Address - Fax:
Practice Address - Street 1:3955 CAMERON PARK DR
Practice Address - Street 2:
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-8203
Practice Address - Country:US
Practice Address - Phone:530-676-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA490001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice