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General NPI Number Information
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NPI Number | 1477806024
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Entity Type | Organization
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Legal Business Name | DR JOHN T DANIELS II DDS PC
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Dates
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Enumeration Date | 10/19/2012
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Last Update Date | 10/19/2012
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Provider Practice Location Address
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Address Line | 5001 5TH ST NW
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City | WASHINGTON
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State | DC
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Zip | 20011-4044
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Country | US
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Telephone | 202-723-8777
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Fax |
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Provider Business Mailing Address
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Address Line | 5001 5TH ST NW
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City | WASHINGTON
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State | DC
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Zip | 20011-4044
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Country | US
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Telephone | 202-723-8777
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN T DANIELS II
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Credential | D.D.S.
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Telephone | 817-271-5665
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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 | 14023
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 0401411980
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 1000695
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License Number State | DC
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