Provider Demographics
NPI:1124264411
Name:STANINEC, MICHAL (DDS, PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAL
Middle Name:
Last Name:STANINEC
Suffix:
Gender:M
Credentials:DDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3580 CALIFORNIA ST.
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1717
Mailing Address - Country:US
Mailing Address - Phone:415-563-2022
Mailing Address - Fax:415-771-7819
Practice Address - Street 1:3580 CALIFORNIA ST
Practice Address - Street 2:SUITE 204
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1717
Practice Address - Country:US
Practice Address - Phone:415-563-2022
Practice Address - Fax:415-781-7819
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-17
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADL029483122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist