Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 11433 | MA |
NPI | 1063566958 |
---|---|
Provider Name | Dr. Stanley Starr |
First Address | Medfield, MA 02052-2518 |
Second Address | Medfield, MA 02052-2518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 08/07/2007 |