Provider Demographics
NPI:1942428594
Name:ROBERT J. STANFORD, DDS, MPH, APC
Entity Type:Organization
Organization Name:ROBERT J. STANFORD, DDS, MPH, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:STANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-433-9255
Mailing Address - Street 1:2741 VISTA WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6373
Mailing Address - Country:US
Mailing Address - Phone:760-433-9255
Mailing Address - Fax:760-433-8986
Practice Address - Street 1:2741 VISTA WAY STE 101
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6373
Practice Address - Country:US
Practice Address - Phone:760-433-9255
Practice Address - Fax:760-433-8986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28887122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty