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General NPI Number Information
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NPI Number | 1962518183
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Entity Type | Organization
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Legal Business Name | SAMUEL DANIELS DDS MS PLLC
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 08/21/2007
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Provider Practice Location Address
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Address Line | 305 W MAIN ST
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City | BRIGHTON
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State | MI
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Zip | 48116-1525
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Country | US
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Telephone | 810-229-2776
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Fax | 810-229-8080
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Provider Business Mailing Address
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Address Line | 305 W MAIN ST
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City | BRIGHTON
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State | MI
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Zip | 48116-1525
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Country | US
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Telephone | 810-229-2776
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Fax | 810-229-8080
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | SAMUEL DANIELS
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Credential | DDS MS PLLC
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Telephone | 810-229-2776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 014293
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License Number State | MI
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