Provider Demographics
NPI:1013226240
Name:CANTU, DANIEL (DDS)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:CANTU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 W. TRENTON RD
Mailing Address - Street 2:
Mailing Address - City:EDINGBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539
Mailing Address - Country:US
Mailing Address - Phone:956-664-1695
Mailing Address - Fax:956-664-1798
Practice Address - Street 1:2601 W. TRENTON RD
Practice Address - Street 2:
Practice Address - City:EDINGBURG
Practice Address - State:TX
Practice Address - Zip Code:78539
Practice Address - Country:US
Practice Address - Phone:956-664-1695
Practice Address - Fax:956-664-1798
Is Sole Proprietor?:No
Enumeration Date:2010-10-06
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX256541223G0001X
CA256541223S0112X
TX265541223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2159501-03Medicaid