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General NPI Number Information
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NPI Number | 1609903541
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Entity Type | Individual
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Provider Name | JARED GARETH DANIELSON DDS
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Gender | Male
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 04/06/2022
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Provider Practice Location Address
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Address Line | 4517 SERRANO PKWY STE 102
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-7569
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Country | US
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Telephone | 916-573-3387
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Fax | 916-919-8521
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Provider Business Mailing Address
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Address Line | 4517 SERRANO PKWY STE 102
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-7569
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Country | US
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Telephone | 916-573-3387
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Fax | 916-919-8521
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 52846
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License Number State | CA
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