Provider Demographics
NPI:1164541371
Name:DANIEL, STEVEN RAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RAY
Last Name:DANIEL
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 1:1255 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-2485
Mailing Address - Country:US
Mailing Address - Phone:615-890-7186
Mailing Address - Fax:615-896-5556
Practice Address - Street 1:1255 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-2485
Practice Address - Country:US
Practice Address - Phone:615-890-7186
Practice Address - Fax:615-896-5556
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS38891223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics