Kenneth L. Stasun D.d.s. a Professional Corporateon

NPI #1831214303 in Half Moon Bay, California

Provider Information

NPI Number: 1831214303
Entity Type: Organization
Organization Name: Kenneth L. Stasun D.d.s. a Professional Corporateon
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: Mar 20, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 423 JOHNSTON ST
City: Half Moon Bay
State: California
ZIP Code: 94019-1717
Phone: (650) 726-7523

Authorized Official

Name: DR. KENNETH LOUIS STASUN, D.D.S.
Title: PRESIDENT ORTHODONTIST
Phone: (650) 726-7523

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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