Individual
ROSS STANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
(828) 337-6736
Mailing address
340 BOATNER RD BLDG 2751, EGLIN AFB, FL 32542-1391
(828) 337-6736
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
111699
MS
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D.0006679-C1
AL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN24506
FL
Other
Enumeration date
08/12/2019
Last updated
10/30/2025
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