Douglas, Stuart R
Douglas, Stuart R is an individual health care provider with primary practice located at 139 N Main St , Cortland NY 13045. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Douglas, Stuart R can be contacted via phone (607) 753-0602.Contact Information
Primary practice address
139 N Main St
Cortland NY 13045
Phone: (607) 753-0602
Fax: (607) 758-8737
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 029842 | New York |
| Dental Providers / General Practice | 1223G0001X | 052962 | New York |
Profile Details
| NPI number | 1821176843 |
|---|---|
| LBN Legal business name | Douglas, Stuart R |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821176843 | NPPES |
| Other | 029842 | DELTA | |
| MEDICAID | 00562652 | DELTA |
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