Provider Demographics
NPI:1932311289
Name:DANIELS, WILLIAM CRAIG (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CRAIG
Last Name:DANIELS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 DOUGLAS BLVD
Mailing Address - Street 2:STE 120
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3993
Mailing Address - Country:US
Mailing Address - Phone:916-789-2200
Mailing Address - Fax:916-789-2202
Practice Address - Street 1:2520 DOUGLAS BLVD
Practice Address - Street 2:#120
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3992
Practice Address - Country:US
Practice Address - Phone:916-789-2200
Practice Address - Fax:916-789-2202
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA312381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice