Provider Demographics
NPI:1649297581
Name:DYMERSKI, DANIEL LEO (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:LEO
Last Name:DYMERSKI
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 1:66 SPRINGER DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2316
Mailing Address - Country:US
Mailing Address - Phone:303-791-9141
Mailing Address - Fax:
Practice Address - Street 1:66 SPRINGER DR
Practice Address - Street 2:SUITE 304
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2316
Practice Address - Country:US
Practice Address - Phone:303-791-9141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COHD 0351122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist