Provider Demographics
NPI:1902958234
Name:KEY, EDWARD STANTON (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:STANTON
Last Name:KEY
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1107 INDIANA ST
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:TX
Mailing Address - Zip Code:76450-4030
Mailing Address - Country:US
Mailing Address - Phone:940-549-6142
Mailing Address - Fax:940-549-7044
Practice Address - Street 1:1107 INDIANA ST
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:TX
Practice Address - Zip Code:76450-4030
Practice Address - Country:US
Practice Address - Phone:940-549-6142
Practice Address - Fax:940-549-7044
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107161223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics