Provider Demographics
NPI:1740599059
Name:BLOCK, DANIEL C (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:C
Last Name:BLOCK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10313 METROPOLITAN AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-6733
Mailing Address - Country:US
Mailing Address - Phone:718-268-7792
Mailing Address - Fax:718-793-1937
Practice Address - Street 1:10313 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-6733
Practice Address - Country:US
Practice Address - Phone:718-268-7792
Practice Address - Fax:718-793-1937
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044386122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist