Healthcare Provider Details

I. General information

NPI: 1942335401
Provider Name (Legal Business Name): ALLEN DALE DANIELS D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 RICHWOOD RD STE 305
WALTON KY
41094-7440
US

IV. Provider business mailing address

24173 STATE LINE RD
LAWRENCEBURG IN
47025
US

V. Phone/Fax

Practice location:
  • Phone: 859-419-0768
  • Fax:
Mailing address:
  • Phone: 812-656-8888
  • Fax: 812-656-8016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberD-00231
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30022681
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS2677
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: