MEDICARE: DANIEL S HALEY DMD PLLC

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1689360315
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL S HALEY DMD PLLC

Provider Business Mailing Address
First Line	:	5 CHENELL DR
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-8503
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 CHENELL DR
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-8503
Country	:	US
Telephone Number	:	603-224-4200
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DANIEL STEVEN HALEY
Credential	:	DMD
Telephone Number	:	781-974-4846

Provider Enumeration Date	:	04/14/2023
Last Update Date	:	04/14/2023

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