Provider Demographics
NPI:1235698887
Name:DANIEL B. STORY II, DMD
Entity Type:Organization
Organization Name:DANIEL B. STORY II, DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-247-3478
Mailing Address - Street 1:701 E FIRST ST
Mailing Address - Street 2:
Mailing Address - City:BELZONI
Mailing Address - State:MS
Mailing Address - Zip Code:39038-3407
Mailing Address - Country:US
Mailing Address - Phone:662-247-3478
Mailing Address - Fax:
Practice Address - Street 1:701 E FIRST ST
Practice Address - Street 2:
Practice Address - City:BELZONI
Practice Address - State:MS
Practice Address - Zip Code:39038-3407
Practice Address - Country:US
Practice Address - Phone:662-247-3478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty