Healthcare Provider Details

I. General information

NPI: 1700722964
Provider Name (Legal Business Name): DANIEL MUROLO, D.D.S. A PROFESSIONAL DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2817 CHILDRESS DR
ANDERSON CA
96007-3563
US

IV. Provider business mailing address

2817 CHILDRESS DR
ANDERSON CA
96007-3563
US

V. Phone/Fax

Practice location:
  • Phone: 530-365-3351
  • Fax: 530-365-2732
Mailing address:
  • Phone: 530-365-3351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DANIEL MUROLO
Title or Position: OWNER/DENTIST
Credential: M.S., D.D.S.
Phone: 607-765-7675