Provider Demographics
NPI:1255538724
Name:WOODS, STANLEY M (DMD)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:M
Last Name:WOODS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 WRIGHTSVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-2153
Mailing Address - Country:US
Mailing Address - Phone:910-409-9843
Mailing Address - Fax:910-342-9211
Practice Address - Street 1:2027 WRIGHTSVILLE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-2153
Practice Address - Country:US
Practice Address - Phone:910-409-9843
Practice Address - Fax:910-342-9211
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC84381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice