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General NPI Number Information
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NPI Number | 1609514504
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Entity Type | Individual
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Provider Name | DEAN DANOS DDS
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Gender | Male
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Dates
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Enumeration Date | 05/22/2022
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Last Update Date | 05/22/2022
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Provider Practice Location Address
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Address Line | 1809 HOMER M ADAMS PKWY STE A
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City | ALTON
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State | IL
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Zip | 62002-5606
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Country | US
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Telephone | 618-433-3410
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Fax |
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Provider Business Mailing Address
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Address Line | 4437 W 103RD ST
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City | OAK LAWN
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State | IL
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Zip | 60453-4855
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Country | US
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Telephone | 708-927-4020
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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 | 019.033587
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License Number State | IL
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