Provider Demographics
NPI:1184983066
Name:DRISKILL, DANIEL W (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:W
Last Name:DRISKILL
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 1:877 E GANNON AVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597-9314
Mailing Address - Country:US
Mailing Address - Phone:919-269-0103
Mailing Address - Fax:919-269-6796
Practice Address - Street 1:877 E GANNON AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:ZEBULON
Practice Address - State:NC
Practice Address - Zip Code:27597-9314
Practice Address - Country:US
Practice Address - Phone:919-269-0103
Practice Address - Fax:919-269-6796
Is Sole Proprietor?:No
Enumeration Date:2012-05-11
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC94471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice