MEDICARE: R. HARRIS DANIEL, D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	4477	NC

General Provider Information

NPI Number	:	1386850188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R. HARRIS DANIEL, D.D.S.

Provider Business Mailing Address
First Line	:	5706 MCLEANSVILLE RD
Second Line	:
City	:	MC LEANSVILLE
State	:	NC
Zip	:	27301-9303
Country	:	US
Telephone Number	:	336-697-0618
Fax Number	:	336-697-9478

Provider Business Practice Location Address
First Line	:	5706 MCLEANSVILLE RD
Second Line	:
City	:	MC LEANSVILLE
State	:	NC
Zip	:	27301-9303
Country	:	US
Telephone Number	:	336-697-0618
Fax Number	:	336-697-9478

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. ROBERT HARRIS DANIEL
Credential	:	DDS
Telephone Number	:	336-697-0618

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	08/22/2020

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