Provider Demographics
NPI:1063566958
Name:STARR, STANLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:
Last Name:STARR
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 1:16 PARK ST
Mailing Address - Street 2:
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-2518
Mailing Address - Country:US
Mailing Address - Phone:508-359-2576
Mailing Address - Fax:508-359-2291
Practice Address - Street 1:16 PARK ST
Practice Address - Street 2:
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-2518
Practice Address - Country:US
Practice Address - Phone:508-359-2576
Practice Address - Fax:508-359-2291
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA114331223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics