Provider Demographics
NPI:1740343227
Name:STONE, PAUL STANLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:STANLEY
Last Name:STONE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 EDINBOROUGH WAY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5958
Mailing Address - Country:US
Mailing Address - Phone:952-831-1112
Mailing Address - Fax:952-831-1839
Practice Address - Street 1:3300 EDINBOROUGH WAY
Practice Address - Street 2:SUITE 210
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5958
Practice Address - Country:US
Practice Address - Phone:952-831-1112
Practice Address - Fax:952-831-1839
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN82711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
13439PAOtherBCBS