Provider Demographics
NPI:1912270984
Name:STIMMLER, BRYAN HAROLD (DDS)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:HAROLD
Last Name:STIMMLER
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 1:169 KENT ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-2105
Mailing Address - Country:US
Mailing Address - Phone:562-895-2532
Mailing Address - Fax:
Practice Address - Street 1:169 KENT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-2105
Practice Address - Country:US
Practice Address - Phone:562-895-2532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-21
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY50055167122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist