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General NPI Number Information
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NPI Number | 1124314075
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Entity Type | Individual
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Provider Name | DAVID DALTON DANIEL D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/20/2011
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Last Update Date | 06/20/2011
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Provider Practice Location Address
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Address Line | 2058 BALTIMORE REYNOLDSBURG RD
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City | REYNOLDSBURG
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State | OH
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Zip | 43068-3261
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Country | US
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Telephone | 614-863-4310
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Fax |
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Provider Business Mailing Address
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Address Line | 203 S WALL ST APT. 316
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City | COLUMBUS
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State | OH
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Zip | 43215-4780
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Country | US
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Telephone | 614-668-7364
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30-023434
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License Number State | OH
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