Provider Demographics
NPI:1568685238
Name:DANIEL II, JAMES EARL (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EARL
Last Name:DANIEL II
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 1:1408 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7552
Mailing Address - Country:US
Mailing Address - Phone:606-325-2469
Mailing Address - Fax:606-325-1622
Practice Address - Street 1:1408 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7552
Practice Address - Country:US
Practice Address - Phone:606-325-2469
Practice Address - Fax:606-325-1622
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY65361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice