Provider Demographics
NPI:1649425620
Name:DR. F. CHARLES STANGE JR. D.D.S P.C.
Entity type:Organization
Organization Name:DR. F. CHARLES STANGE JR. D.D.S P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:F.
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:STANGE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-436-7700
Mailing Address - Street 1:711 GREENBRIER PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3689
Mailing Address - Country:US
Mailing Address - Phone:757-436-7700
Mailing Address - Fax:757-436-7011
Practice Address - Street 1:711 GREENBRIER PKWY STE 101
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3689
Practice Address - Country:US
Practice Address - Phone:757-436-7700
Practice Address - Fax:757-436-7011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401004579122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty