Provider Demographics
NPI:1962786301
Name:DANKWORTH, STEPHEN RICHARD (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:RICHARD
Last Name:DANKWORTH
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 1:7730 RANCHO SANTA FE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-8688
Mailing Address - Country:US
Mailing Address - Phone:760-633-3033
Mailing Address - Fax:760-633-3990
Practice Address - Street 1:7730 RANCHO SANTA FE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-8688
Practice Address - Country:US
Practice Address - Phone:760-633-3033
Practice Address - Fax:760-633-3990
Is Sole Proprietor?:No
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADB 0332731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice