Provider Demographics
NPI:1295803542
Name:GIRDLESTONE, STEPHEN PATRICK (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:PATRICK
Last Name:GIRDLESTONE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3801 WHIPPLE AVE SUITE 4
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718
Mailing Address - Country:US
Mailing Address - Phone:330-491-7777
Mailing Address - Fax:330-491-8888
Practice Address - Street 1:3801 WHIPPLE AVE NW
Practice Address - Street 2:SUITE 4
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-4802
Practice Address - Country:US
Practice Address - Phone:330-491-7777
Practice Address - Fax:330-491-8888
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0205531223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry