Provider Demographics
NPI:1124145420
Name:STANZ, KARLA MICHELLE (DMD)
Entity type:Individual
Prefix:DR
First Name:KARLA
Middle Name:MICHELLE
Last Name:STANZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3787 NICHOLAS STREET
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045
Mailing Address - Country:US
Mailing Address - Phone:610-252-8558
Mailing Address - Fax:610-252-8885
Practice Address - Street 1:3787 NICHOLAS STREET
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045
Practice Address - Country:US
Practice Address - Phone:610-252-8558
Practice Address - Fax:610-252-8885
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS031490L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist