Provider Demographics
NPI:1780316380
Name:STAHLEY, COREY (DDS)
Entity type:Individual
Prefix:DR
First Name:COREY
Middle Name:
Last Name:STAHLEY
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 1:14005 US-183 HWY
Mailing Address - Street 2:STE. 800
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78681
Mailing Address - Country:US
Mailing Address - Phone:512-266-7200
Mailing Address - Fax:
Practice Address - Street 1:14005 US-183 HWY
Practice Address - Street 2:STE. 800
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717
Practice Address - Country:US
Practice Address - Phone:512-266-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC51343122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist