Provider Demographics
NPI:1710969761
Name:BYRNE, DANIEL R (DMD PS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:R
Last Name:BYRNE
Suffix:
Gender:M
Credentials:DMD PS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6659 KIMBALL DR
Mailing Address - Street 2:SUITE D 401
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-5137
Mailing Address - Country:US
Mailing Address - Phone:253-858-9169
Mailing Address - Fax:253-853-6681
Practice Address - Street 1:6659 KIMBALL DR
Practice Address - Street 2:SUITE D 401
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-5137
Practice Address - Country:US
Practice Address - Phone:253-858-9169
Practice Address - Fax:253-853-6681
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA68461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice