Provider Demographics
NPI:1639555329
Name:DAYAN, DAVID MOSHE (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MOSHE
Last Name:DAYAN
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1464 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5503
Mailing Address - Country:US
Mailing Address - Phone:917-386-7676
Mailing Address - Fax:
Practice Address - Street 1:1464 E 3RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5503
Practice Address - Country:US
Practice Address - Phone:917-386-7676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0581081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics