Provider Demographics
NPI:1083980882
Name:DEMARAY, DANIEL DUANE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:DUANE
Last Name:DEMARAY
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 1:1079 TERRACINA DR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-5425
Mailing Address - Country:US
Mailing Address - Phone:916-612-1358
Mailing Address - Fax:
Practice Address - Street 1:1079 TERRACINA DR
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-5425
Practice Address - Country:US
Practice Address - Phone:916-612-1358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0258781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice