Provider Demographics
NPI:1154525996
Name:DR. STEPHEN J. VANYO DMD PA
Entity type:Organization
Organization Name:DR. STEPHEN J. VANYO DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:T
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-471-4630
Mailing Address - Street 1:3004 GUESS RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2667
Mailing Address - Country:US
Mailing Address - Phone:919-471-4630
Mailing Address - Fax:919-477-3517
Practice Address - Street 1:3004 GUESS RD
Practice Address - Street 2:SUITE C
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2667
Practice Address - Country:US
Practice Address - Phone:919-471-4630
Practice Address - Fax:919-477-3517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC57831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty