Provider Demographics
NPI:1932112406
Name:STEWART, DANIEL M (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:M
Last Name:STEWART
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 1:1001 BUCKINGHAM RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5850
Mailing Address - Country:US
Mailing Address - Phone:972-680-1606
Mailing Address - Fax:972-680-1645
Practice Address - Street 1:1001 BUCKINGHAM RD
Practice Address - Street 2:SUITE 108
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5850
Practice Address - Country:US
Practice Address - Phone:972-680-1606
Practice Address - Fax:972-680-1645
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX125061223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics