Provider Demographics
NPI:1871652966
Name:DANIELS, GEORGE III
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:DANIELS
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 S HAMPTON RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75232-1066
Mailing Address - Country:US
Mailing Address - Phone:214-943-1311
Mailing Address - Fax:214-943-5125
Practice Address - Street 1:4650 S HAMPTON RD
Practice Address - Street 2:SUITE 103
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75232-1066
Practice Address - Country:US
Practice Address - Phone:214-943-1311
Practice Address - Fax:214-943-5125
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX164181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice