Provider Demographics
NPI:1659501732
Name:DANIELS, STEPHEN E (DMD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:E
Last Name:DANIELS
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 1:1183 STANFORD RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:KY
Mailing Address - Zip Code:40444-9567
Mailing Address - Country:US
Mailing Address - Phone:859-792-4236
Mailing Address - Fax:859-792-6033
Practice Address - Street 1:1183 STANFORD RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:KY
Practice Address - Zip Code:40444-9567
Practice Address - Country:US
Practice Address - Phone:859-792-4236
Practice Address - Fax:859-792-6033
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY87441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice