Provider Demographics
NPI:1841458379
Name:STANSBURY PLLC, CHRISTOPHER (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:STANSBURY PLLC
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10119 LAKE CREEK PARKWAY
Mailing Address - Street 2:SUITE #1
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729
Mailing Address - Country:US
Mailing Address - Phone:512-258-6979
Mailing Address - Fax:512-250-0381
Practice Address - Street 1:10119 LAKE CREEK PARKWAY
Practice Address - Street 2:SUITE #1
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729
Practice Address - Country:US
Practice Address - Phone:512-258-6979
Practice Address - Fax:512-250-0381
Is Sole Proprietor?:No
Enumeration Date:2008-05-31
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019027131122300000X
GADN013844122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist