Individual
DR. GARY EDWARD STAADT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1204 E NATIONAL AVE, BRAZIL, IN 47834-2718
(812) 446-1211
Mailing address
1204 E NATIONAL AVE, P.O. BOX 603, BRAZIL, IN 47834-2718
(812) 446-1211
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12008618A
IN
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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