Provider Demographics
NPI:1033432695
Name:JAMES G DALY D.D.S.
Entity Type:Organization
Organization Name:JAMES G DALY D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:G
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:802-388-4432
Mailing Address - Street 1:152 MAPLE ST.
Mailing Address - Street 2:STE. 201
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753
Mailing Address - Country:US
Mailing Address - Phone:802-388-4432
Mailing Address - Fax:802-388-7457
Practice Address - Street 1:152 MAPLE ST.
Practice Address - Street 2:STE. 201
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753
Practice Address - Country:US
Practice Address - Phone:802-388-4432
Practice Address - Fax:802-388-7457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0001712Medicaid