Provider Demographics
NPI:1992839039
Name:BATTLE, STACY ANN (DDS)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:ANN
Last Name:BATTLE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:ANN
Other - Last Name:BATTLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:6028 TROOST AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64110
Mailing Address - Country:US
Mailing Address - Phone:816-444-9191
Mailing Address - Fax:816-363-0878
Practice Address - Street 1:6028 TROOST AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110
Practice Address - Country:US
Practice Address - Phone:816-444-9191
Practice Address - Fax:816-363-0878
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO13175122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist