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General NPI Number Information
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NPI Number | 1700235207
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Entity Type | Individual
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Provider Name | DANIEL MICHAEL MARGOLIS DMD, MD
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Gender | Male
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Dates
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Enumeration Date | 06/07/2016
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 1752 BROAD PARK CIR N STE 100
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City | MANSFIELD
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State | TX
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Zip | 76063-7824
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Country | US
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Telephone | 714-651-2728
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Fax |
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Provider Business Mailing Address
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Address Line | 1208 NE WINDSOR DR
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City | LEES SUMMIT
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State | MO
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Zip | 64086-5594
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Country | US
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Telephone | 714-651-2728
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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 | 2016017198
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 2016017198
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 37144
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License Number State | TX
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