Healthcare Provider Details

I. General information

NPI: 1285258715
Provider Name (Legal Business Name): DANIEL DUARTE DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2020
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 N IRBY ST
FLORENCE SC
29501-2808
US

IV. Provider business mailing address

360 N IRBY ST
FLORENCE SC
29501-2808
US

V. Phone/Fax

Practice location:
  • Phone: 843-667-9414
  • Fax:
Mailing address:
  • Phone: 843-667-9414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License NumberDEN4796
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10976
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: