Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DN1857877 | MA |
NPI | 1053708370 |
---|---|
Provider Name | Dr. Michael Stangler |
First Address | Stoneham, MA 02180-1207 |
Second Address | Stoneham, MA 02180 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2015 |
Last Update Date | 02/08/2021 |