Provider Demographics
NPI:1952852618
Name:DANI STANSELL DDS PA 2
Entity Type:Organization
Organization Name:DANI STANSELL DDS PA 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANI
Authorized Official - Middle Name:
Authorized Official - Last Name:STANSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-327-1770
Mailing Address - Street 1:1911 FALLS VALLEY DR
Mailing Address - Street 2:107
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2495
Mailing Address - Country:US
Mailing Address - Phone:919-327-1770
Mailing Address - Fax:
Practice Address - Street 1:1911 FALLS VALLEY DR
Practice Address - Street 2:107
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2495
Practice Address - Country:US
Practice Address - Phone:919-327-1770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8585122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty