Provider Demographics
NPI:1417125816
Name:ARREDONDO, DANIEL G (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:G
Last Name:ARREDONDO
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 1:3740 COLONY DR
Mailing Address - Street 2:SUITE 254
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-2234
Mailing Address - Country:US
Mailing Address - Phone:210-690-5170
Mailing Address - Fax:210-690-8522
Practice Address - Street 1:3740 COLONY DR
Practice Address - Street 2:SUITE 254
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-2234
Practice Address - Country:US
Practice Address - Phone:210-690-5170
Practice Address - Fax:210-690-8522
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7421293541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice