Provider Demographics
NPI:1740308741
Name:MOLLOY, DANIEL J (DMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:MOLLOY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:30 HIGGINS CROWELL ROAD
Mailing Address - Street 2:
Mailing Address - City:WEST YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02673
Mailing Address - Country:US
Mailing Address - Phone:508-771-3336
Mailing Address - Fax:508-798-9210
Practice Address - Street 1:30 HIGGINS CROWELL ROAD
Practice Address - Street 2:
Practice Address - City:WEST YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02673
Practice Address - Country:US
Practice Address - Phone:508-771-3336
Practice Address - Fax:508-798-9210
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA165681223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics