Individual
DR. STANLEY TRISTEZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5204 HIGHWAY 51 N, SENATOBIA, MS 38668-1712
(662) 562-9868
(662) 562-9822
Mailing address
5204 HIGHWAY 51 N, SENATOBIA, MS 38668-1712
(662) 562-9868
(662) 562-9822
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4282-22
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4282-22
MS STATE LICENSE
MS
Enumeration date
06/08/2022
Last updated
06/08/2022
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