Provider Demographics
NPI:1043239635
Name:SCHIAVONE, DANIEL WAYNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:WAYNE
Last Name:SCHIAVONE
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 1:69 PUBLIC SQ
Mailing Address - Street 2:
Mailing Address - City:HOLLEY
Mailing Address - State:NY
Mailing Address - Zip Code:14470-1139
Mailing Address - Country:US
Mailing Address - Phone:585-638-7645
Mailing Address - Fax:
Practice Address - Street 1:69 PUBLIC SQ
Practice Address - Street 2:
Practice Address - City:HOLLEY
Practice Address - State:NY
Practice Address - Zip Code:14470-1139
Practice Address - Country:US
Practice Address - Phone:585-638-7645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045588122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist