BRIAN A. STARK D.D.S. S.C. NPI 1609930627

NPI Information

NPI: 1609930627
Provider Name: BRIAN A. STARK, D.D.S., S.C.

Doing Business As: AVENUE DENTAL GROUP

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
N84W15959 APPLETON AVE
MENOMONEE FALLS, WI
ZIP 53051
Phone: (262) 251-6555
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BRIAN A. STARK, D.D.S., S.C. is a dental clinic center in Menomonee Falls, WI. BRIAN A. STARK, D.D.S., S.C. NPI is 1609930627. The provider is registered as an organization entity type.
The provider Is Doing Business As Avenue Dental Group.

The provider's business location address is:

N84W15959 APPLETON AVE
MENOMONEE FALLS, WI
ZIP 53051-044
Phone: (262) 251-6555
Fax: (262) 251-9518

The provider's authorized official is Brian Anthony Stark .
The authorized official title is President and has the following contact phone number (262) 251-6555.

The enumeration date for this NPI number is 12/21/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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