Provider Demographics
NPI:1891974069
Name:STANLEY, JAMES L (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:L
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 1:3712 OLD FOREST RD BLDG 100
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-6900
Mailing Address - Country:US
Mailing Address - Phone:434-385-0273
Mailing Address - Fax:434-385-6269
Practice Address - Street 1:3712 OLD FOREST RD BLDG 100
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-6900
Practice Address - Country:US
Practice Address - Phone:434-385-0273
Practice Address - Fax:434-385-6269
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010056411223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics