Provider Demographics
NPI:1457441107
Name:GIATRELIS, DANIEL N (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:N
Last Name:GIATRELIS
Suffix:
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 1:515 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-1742
Mailing Address - Country:US
Mailing Address - Phone:781-662-6645
Mailing Address - Fax:781-662-9071
Practice Address - Street 1:515 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-1742
Practice Address - Country:US
Practice Address - Phone:781-662-6645
Practice Address - Fax:781-662-9071
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA176351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice