Provider Demographics
NPI:1790748614
Name:STANLEY, JAMES HOWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HOWARD
Last Name:STANLEY
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 1:1107 E MARSHALL AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-5602
Mailing Address - Country:US
Mailing Address - Phone:903-758-2610
Mailing Address - Fax:903-757-2142
Practice Address - Street 1:1107 E MARSHALL AVE
Practice Address - Street 2:SUITE C
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5602
Practice Address - Country:US
Practice Address - Phone:903-758-2610
Practice Address - Fax:903-757-2142
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice