Provider Demographics
NPI:1548323710
Name:STANYA, ANDREW EDWARD (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:EDWARD
Last Name:STANYA
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1919 LATHROP ST.
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-5942
Mailing Address - Country:US
Mailing Address - Phone:907-452-1200
Mailing Address - Fax:907-452-1352
Practice Address - Street 1:1919 LATHROP ST
Practice Address - Street 2:SUITE 210
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-5930
Practice Address - Country:US
Practice Address - Phone:907-452-1200
Practice Address - Fax:907-452-1352
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AKAA 6451223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics