Provider Demographics
NPI:1396701686
Name:LAYMAN, STACEY C (DDS)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:C
Last Name:LAYMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 W EUGIE AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304-1258
Mailing Address - Country:US
Mailing Address - Phone:623-299-8799
Mailing Address - Fax:623-299-8799
Practice Address - Street 1:8415 N PIMA RD STE 275
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4488
Practice Address - Country:US
Practice Address - Phone:623-299-8799
Practice Address - Fax:623-299-8799
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD5894122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist