Provider Demographics
NPI:1396825121
Name:GO, DANIEL Y (DDS)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:Y
Last Name:GO
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 1:333 RAINIER AVE N STE 201
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-5358
Mailing Address - Country:US
Mailing Address - Phone:425-226-1990
Mailing Address - Fax:425-228-6806
Practice Address - Street 1:333 RAINIER AVE N STE 201
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5358
Practice Address - Country:US
Practice Address - Phone:425-226-1990
Practice Address - Fax:425-228-6806
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6122122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist