Provider Demographics
NPI:1891919791
Name:ATKINSON, STANLEY WAYNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:WAYNE
Last Name:ATKINSON
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 1:1209 N DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93907-1996
Mailing Address - Country:US
Mailing Address - Phone:831-424-4777
Mailing Address - Fax:831-755-1917
Practice Address - Street 1:1209 N DAVIS RD
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93907-1996
Practice Address - Country:US
Practice Address - Phone:831-424-4777
Practice Address - Fax:831-755-1917
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice