Provider Demographics
NPI:1912219940
Name:EASTMAN, DANIEL DOUGLAS (DDS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:DOUGLAS
Last Name:EASTMAN
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 1:32 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:HAMLIN
Mailing Address - State:TX
Mailing Address - Zip Code:79520-4022
Mailing Address - Country:US
Mailing Address - Phone:325-576-2271
Mailing Address - Fax:325-576-3445
Practice Address - Street 1:32 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HAMLIN
Practice Address - State:TX
Practice Address - Zip Code:79520-4022
Practice Address - Country:US
Practice Address - Phone:325-576-2271
Practice Address - Fax:325-576-3445
Is Sole Proprietor?:No
Enumeration Date:2010-07-07
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00255931223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice