Individual
TRACY E STANSBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1101 W 6TH ST, STE 100, THE DALLES, OR 97058
(541) 296-3204
Mailing address
1101 W 6TH ST, STE 100, THE DALLES, OR 97058
(541) 296-3204
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7094
OR
Other
Enumeration date
10/31/2006
Last updated
07/08/2007
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