Individual
SCOTT RICHARD STANKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2050 MARQUETTE RD, SUITE 400, PERU, IL 61354-1597
(815) 224-4144
(815) 224-4192
Mailing address
2050 MARQUETTE RD, SUITE 400, PERU, IL 61354-1597
(815) 224-4144
(815) 224-4192
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
IL
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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