Provider Demographics
NPI:1639544174
Name:DANIEL A FLORES, DDS, MS, INC
Entity Type:Organization
Organization Name:DANIEL A FLORES, DDS, MS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-745-1831
Mailing Address - Street 1:245 N RANCHO SANTA FE RD
Mailing Address - Street 2:STE. 207
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-1278
Mailing Address - Country:US
Mailing Address - Phone:760-591-0167
Mailing Address - Fax:
Practice Address - Street 1:245 N RANCHO SANTA FE RD
Practice Address - Street 2:STE. 207
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-1278
Practice Address - Country:US
Practice Address - Phone:760-591-0167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DANIEL A FLORES, DDS, MS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30685261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental