Provider Demographics
NPI:1326159138
Name:ENGER, DANIEL J JR (DDS)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:J
Last Name:ENGER
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4105 HOSPITAL STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PASCAGOULA
Mailing Address - State:MS
Mailing Address - Zip Code:39581-5312
Mailing Address - Country:US
Mailing Address - Phone:228-762-4403
Mailing Address - Fax:228-762-4409
Practice Address - Street 1:4105 HOSPITAL STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39581-5312
Practice Address - Country:US
Practice Address - Phone:228-762-4403
Practice Address - Fax:228-762-4409
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS19231223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4005902OtherBCBS OF TN
MS795890OtherUNITED CONCORDIA
AL730-12358OtherBCBS OF AL
TXV01923OtherBCBS OF TX