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General NPI Number Information
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NPI Number | 1073024634
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Entity Type | Organization
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Legal Business Name | DANIELLE J DEY DDS, LLC
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Dates
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Enumeration Date | 10/22/2017
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Last Update Date | 03/16/2018
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Provider Practice Location Address
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Address Line | 10991B NATIONAL RD SW
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City | ETNA
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State | OH
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Zip | 43062-8107
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Country | US
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Telephone | 740-785-7444
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Fax |
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Provider Business Mailing Address
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Address Line | 10991B NATIONAL RD SW
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City | ETNA
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State | OH
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Zip | 43062-8107
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Country | US
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Telephone | 740-785-7444
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Fax |
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Authorized Official
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Title or Position | OWNER/GENERAL DENTIST
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Name | DR. DANIELLE J DEY
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Credential | DDS
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Telephone | 740-785-7444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 30.024073
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License Number State | OH
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