Provider Demographics
NPI:1437481108
Name:DAILEY, JAMES DARRELL JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DARRELL
Last Name:DAILEY
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 N. LAFEYETTE DR.
Mailing Address - Street 2:SUITE C
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-2964
Mailing Address - Country:US
Mailing Address - Phone:803-774-3600
Mailing Address - Fax:803-774-4560
Practice Address - Street 1:1105 N. LAFEYETTE DR.
Practice Address - Street 2:SUITE C
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-2964
Practice Address - Country:US
Practice Address - Phone:803-774-3600
Practice Address - Fax:803-774-4560
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2631122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist