Provider Demographics
NPI:1790105013
Name:EYER, DANIEL (DDS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:EYER
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 1:1485 MAIN STREET SUITE102
Mailing Address - Street 2:
Mailing Address - City:ST HELENA
Mailing Address - State:CA
Mailing Address - Zip Code:94574
Mailing Address - Country:US
Mailing Address - Phone:707-963-2339
Mailing Address - Fax:
Practice Address - Street 1:1485 MAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT HELENA
Practice Address - State:CA
Practice Address - Zip Code:94574-1850
Practice Address - Country:US
Practice Address - Phone:707-963-2339
Practice Address - Fax:707-963-7920
Is Sole Proprietor?:No
Enumeration Date:2014-04-25
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27125122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist