Provider Demographics
NPI:1215167788
Name:STANGL, DAVID PAUL JR (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:STANGL
Suffix:JR
Gender:M
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:PO BOX 2954
Mailing Address - Street 2:
Mailing Address - City:CRESTED BUTTE
Mailing Address - State:CO
Mailing Address - Zip Code:81224-2954
Mailing Address - Country:US
Mailing Address - Phone:970-349-5880
Mailing Address - Fax:
Practice Address - Street 1:412 ELK AVENUE
Practice Address - Street 2:
Practice Address - City:CRESTED BUTTE
Practice Address - State:CO
Practice Address - Zip Code:81224
Practice Address - Country:US
Practice Address - Phone:703-495-8809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-19
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN 9984122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist