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1417018805
STANLEY DEITZ
WATERBURY, CT
NPI
1417018805
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: CT 004084)
Enumeration Date
2006-12-12
Last Update Date
2007-07-08
Business Address
STANLEY DEITZ DMD OMS
188 CHASE AVE
WATERBURY, CT 06704-2245
Phone number: 203-754-3818
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Mailing Address
STANLEY DEITZ DMD OMS
PO BOX 3189
SYRACUSE, NY 13220-3189
Phone number: 315-454-6000
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