Provider Demographics
NPI:1013005776
Name:O'TOOLE, DANIEL FRANCIS
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:FRANCIS
Last Name:O'TOOLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 GOLFSIDE DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1410
Mailing Address - Country:US
Mailing Address - Phone:734-434-2080
Mailing Address - Fax:
Practice Address - Street 1:2900 GOLFSIDE DR
Practice Address - Street 2:SUITE 7
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-1410
Practice Address - Country:US
Practice Address - Phone:734-434-2080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI107151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice