Provider Demographics
NPI:1922099704
Name:KASS, STANLEY JEROME (DDS)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:JEROME
Last Name:KASS
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 1:434 OLD CONNECTICUT PATH
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-4541
Mailing Address - Country:US
Mailing Address - Phone:508-626-2402
Mailing Address - Fax:
Practice Address - Street 1:434 OLD CONNECTICUT PATH
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-4541
Practice Address - Country:US
Practice Address - Phone:508-626-2402
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA121291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice