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Organization
RICHARD J STALLER DDS PA
Active
Organization
RICHARD J STALLER DDS PA
Active
Other names
Advanced Dentistry South Florida
Organization subpart
No
Provider details
NPI number
Authorized official
KELLI N CARTER (OFFICE MANAGER)
(561) 495-2099
Entity
Organization
Contact information
Practice address
15340 JOG ROAD SUITE 100, DELRAY BEACH, FL 33446-6537
(561) 495-2099
Mailing address
15340 JOG ROAD SUITE 100, DELRAY BEACH, FL 33446-6537
(561) 495-2099
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
10823
FL
1223E0200X
Endodontics
6099
FL
1223G0001X
General Practice Dentistry
Primary
9129
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
9191
FL
Other
Enumeration date
11/15/2013
Last updated
10/16/2015
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