Provider Demographics
NPI:1720195936
Name:DANIEL P. HARTLEY, DMD, PA
Entity Type:Organization
Organization Name:DANIEL P. HARTLEY, DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:HARTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:864-833-5400
Mailing Address - Street 1:103 CALVERT AVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:SC
Mailing Address - Zip Code:29325-2514
Mailing Address - Country:US
Mailing Address - Phone:864-833-5333
Mailing Address - Fax:864-833-5417
Practice Address - Street 1:103 CALVERT AVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:SC
Practice Address - Zip Code:29325-2514
Practice Address - Country:US
Practice Address - Phone:864-833-5333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC 1743122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty