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General NPI Number Information
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NPI Number | 1528210176
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Entity Type | Organization
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Legal Business Name | DANIEL P. MOYLAN D.D.S. PLLC
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Dates
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Enumeration Date | 10/15/2008
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Last Update Date | 10/15/2008
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Provider Practice Location Address
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Address Line | 877 E M 32
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City | GAYLORD
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State | MI
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Zip | 49735-9701
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Country | US
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Telephone | 989-732-1213
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Fax | 989-731-0321
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Provider Business Mailing Address
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Address Line | 877 M-32 EAST
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City | GAYLORD
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State | MI
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Zip | 49735
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Country | US
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Telephone | 989-732-1213
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Fax | 989-731-0321
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIEL P MOYLAN
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Credential | DDS
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Telephone | 989-732-1213
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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 | 2901019359
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License Number State | MI
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