Provider Demographics
NPI:1972710267
Name:REMLEY, DAN K (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:K
Last Name:REMLEY
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 1:9880 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:GALESBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49053-8641
Mailing Address - Country:US
Mailing Address - Phone:269-665-7005
Mailing Address - Fax:269-665-7680
Practice Address - Street 1:10953 N. 42ND ST.
Practice Address - Street 2:
Practice Address - City:HICKORY CORNERS
Practice Address - State:MI
Practice Address - Zip Code:49060
Practice Address - Country:US
Practice Address - Phone:269-665-7005
Practice Address - Fax:269-665-7680
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI092691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice