Provider Demographics
NPI:1033310750
Name:W. DANIEL ALDER DDS MS INC
Entity Type:Organization
Organization Name:W. DANIEL ALDER DDS MS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MCWILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-385-8620
Mailing Address - Street 1:160 S MULBERRY ST
Mailing Address - Street 2:PO BOX 551
Mailing Address - City:LOGAN
Mailing Address - State:OH
Mailing Address - Zip Code:43138-1292
Mailing Address - Country:US
Mailing Address - Phone:740-385-8620
Mailing Address - Fax:740-385-3073
Practice Address - Street 1:160 S MULBERRY ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:OH
Practice Address - Zip Code:43138-1292
Practice Address - Country:US
Practice Address - Phone:740-385-8620
Practice Address - Fax:740-385-3073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH130251223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty