Provider Demographics
NPI:1720391873
Name:DANIEL R BYRNE DMD ALAN MACKS DMD PS
Entity Type:Organization
Organization Name:DANIEL R BYRNE DMD ALAN MACKS DMD PS
Other - Org Name:KITSAP GENTLE DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-698-1990
Mailing Address - Street 1:9910 LEVIN RD NW STE 100
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-7789
Mailing Address - Country:US
Mailing Address - Phone:360-698-1990
Mailing Address - Fax:360-698-2255
Practice Address - Street 1:9910 LEVIN RD NW STE 100
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7789
Practice Address - Country:US
Practice Address - Phone:360-698-1990
Practice Address - Fax:360-698-2255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA68461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty