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General NPI Number Information
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NPI Number | 1366812646
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Entity Type | Organization
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Legal Business Name | DANIEL C. PURDY, D.M.D INC
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Dates
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Enumeration Date | 09/30/2015
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Last Update Date | 12/08/2016
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Provider Practice Location Address
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Address Line | 5397 TRUXTUN AVE
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0641
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Country | US
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Telephone | 661-832-5530
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Fax | 661-832-0137
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Provider Business Mailing Address
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Address Line | 5397 TRUXTUN AVE
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0641
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Country | US
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Telephone | 661-832-5530
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Fax | 661-832-0137
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | STACY BOZEMAN
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Credential |
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Telephone | 661-832-5530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 47411
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License Number State | CA
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