Individual
DR. GLENN R STANISLAUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1003 RICHMOND AVE, STATEN ISLAND, NY 10314-1501
(718) 477-5588
(718) 477-5550
Mailing address
1003 RICHMOND AVE, STATEN ISLAND, NY 10314-1501
(718) 477-5588
(718) 477-5550
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0424921
NY
Other
Enumeration date
04/02/2014
Last updated
04/02/2014
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