Provider Demographics
NPI:1164489993
Name:KENNETH F MCDANIEL DDS PC
Entity Type:Organization
Organization Name:KENNETH F MCDANIEL DDS PC
Other - Org Name:HARTLAND SMILEMAKERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:F
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:810-632-5533
Mailing Address - Street 1:11499 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48353-2709
Mailing Address - Country:US
Mailing Address - Phone:810-632-5566
Mailing Address - Fax:810-632-7556
Practice Address - Street 1:11499 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:MI
Practice Address - Zip Code:48353-2709
Practice Address - Country:US
Practice Address - Phone:810-632-5566
Practice Address - Fax:810-632-7556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty