Provider Demographics
NPI:1023260635
Name:CONSTANDSE, DANIEL OSCAR (DDS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:OSCAR
Last Name:CONSTANDSE
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:P. O. BOX 962707
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79996-2707
Mailing Address - Country:US
Mailing Address - Phone:915-855-8874
Mailing Address - Fax:915-921-7842
Practice Address - Street 1:1369 AVE. AMERICAS
Practice Address - Street 2:
Practice Address - City:JUAREZ
Practice Address - State:CHIHUAHUA
Practice Address - Zip Code:32310
Practice Address - Country:MX
Practice Address - Phone:915-849-6736
Practice Address - Fax:915-921-7842
Is Sole Proprietor?:No
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ1768811223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics