Organization
KENNETH L. STASUN D.D.S. A PROFESSIONAL CORPORATEON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH LOUIS STASUN D.D.S. (PRESIDENT ORTHODONTIST)
(650) 726-7523
Entity
Organization
Contact information
Practice address
423 JOHNSTON ST, HALF MOON BAY, CA 94019-1717
(650) 726-7523
Mailing address
423 JOHNSTON ST, HALF MOON BAY, CA 94019-1717
(650) 726-7523
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
21516
CA
Other
Enumeration date
03/20/2007
Last updated
08/22/2020
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