Provider Demographics
NPI:1982880639
Name:STANCIL, CECIL PHILLIP JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:CECIL
Middle Name:PHILLIP
Last Name:STANCIL
Suffix:JR
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 1:7118 SONYA DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-5232
Mailing Address - Country:US
Mailing Address - Phone:615-207-1932
Mailing Address - Fax:
Practice Address - Street 1:1147 S HAIRSTON RD
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30088-2716
Practice Address - Country:US
Practice Address - Phone:404-297-6635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0136671223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery