Individual
WILLIAM S STATEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1250 SOUTHWINDS DR, PBCPH - LANTANA HEALTH CENTER DENTAL CLINIC, LANTANA, FL 33462-1459
(561) 547-6811
(561) 540-1107
Mailing address
107 W INDIAN CROSSING CIR, JUPITER, FL 33458-5276
(561) 630-5730
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
11165
FL
1223D0001X
Public Health Dentistry
Primary
11165
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0736431-00
—
FL
Enumeration date
09/01/2006
Last updated
01/31/2013
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