Individual
STANLEY STEWART
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
7401 N UNIVERSITY DR, 102, TAMARAC, FL 33321-2979
(954) 721-7990
(954) 720-9484
Mailing address
7401 N UNIVERSITY DR, 102, TAMARAC, FL 33321-2979
(954) 721-7990
(954) 720-9484
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DN0006161
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85239A
BLUE CROSS BLUE SHIELD
FL
01
—
S70701
UNITED CONCORDIA
FL
Enumeration date
06/09/2006
Last updated
07/08/2007
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