Individual
BRENT RICHARD STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
500 N ESTRELLA PKWY, SUITE B-1, GOODYEAR, AZ 85338-4135
(623) 882-0782
(623) 882-0878
Mailing address
500 N ESTRELLA PKWY, SUITE B-1, GOODYEAR, AZ 85338-4135
(623) 882-0782
(623) 882-0878
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6619
AZ
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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