Provider Demographics
NPI:1437327368
Name:STANLEY M. LEVENSON, DMD,P.C
Entity type:Organization
Organization Name:STANLEY M. LEVENSON, DMD,P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:LEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, PC
Authorized Official - Phone:508-753-3105
Mailing Address - Street 1:9 LINDEN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-3243
Mailing Address - Country:US
Mailing Address - Phone:508-753-3105
Mailing Address - Fax:
Practice Address - Street 1:9 LINDEN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-2510
Practice Address - Country:US
Practice Address - Phone:508-753-3105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16437261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental