Provider Demographics
NPI:1932245677
Name:FELDMAN, STANLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:
Last Name:FELDMAN
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:PO BOX 1016 169 PROSPECT HILL RD
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06088
Mailing Address - Country:US
Mailing Address - Phone:860-623-7313
Mailing Address - Fax:860-623-4825
Practice Address - Street 1:169 PROSPECT HILL RD
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06088
Practice Address - Country:US
Practice Address - Phone:860-623-7313
Practice Address - Fax:860-623-4825
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4507122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist