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General NPI Number Information
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NPI Number | 1902730948
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Entity Type | Individual
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Provider Name | JAMES RICHARD FOUNTAYNE DANIELL BCD, MBBS
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Gender | Male
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Dates
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Enumeration Date | 06/12/2026
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Last Update Date | 06/12/2026
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Provider Practice Location Address
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Address Line | 300 LONGWOOD AVENUE BOSTON'S CHILDREN'S HOSPITAL DEPARTMENT OF PLASTIC & OR
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City | BOSTON
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State | MA
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Zip | 02115
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Country | US
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Telephone | 617-355-2313
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Fax |
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Provider Business Mailing Address
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Address Line | 300 LONGWOOD AVENUE BOSTON'S CHILDREN'S HOSPITAL DEPARTMENT OF PLASTIC & OR
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City | BOSTON
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State | MA
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Zip | 02115
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Country | US
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Telephone | 617-355-2313
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DFNE10111
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License Number State | MA
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