Provider Demographics
NPI:1508190919
Name:BERNAL, DANIEL (DDS)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:BERNAL
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 1:13345 TELEGRAPH RD
Mailing Address - Street 2:# L
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-3200
Mailing Address - Country:US
Mailing Address - Phone:562-903-9342
Mailing Address - Fax:562-941-8791
Practice Address - Street 1:13345 TELEGRAPH RD
Practice Address - Street 2:# L
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-3200
Practice Address - Country:US
Practice Address - Phone:562-903-9342
Practice Address - Fax:562-941-8791
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58714122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist