Healthcare Provider Details

I. General information

NPI: 1114357167
Provider Name (Legal Business Name): DANIELLE JACQUELENE DEY D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DANIELLE JACQUELENE ROYER DDS

II. Dates (important events)

Enumeration Date: 11/12/2013
Last Update Date: 03/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10991B NATIONAL RD SW
ETNA OH
43062-8107
US

IV. Provider business mailing address

10991B NATIONAL RD SW
ETNA OH
43062-8107
US

V. Phone/Fax

Practice location:
  • Phone: 740-785-7444
  • Fax:
Mailing address:
  • Phone: 740-785-7444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30-024073
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: