Provider Demographics
NPI:1780905281
Name:HARKEY, DANIEL (DDS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:HARKEY
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 1:104 S LINCOLN AVE
Mailing Address - Street 2:P O BOX 585
Mailing Address - City:MANSFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65704-0585
Mailing Address - Country:US
Mailing Address - Phone:417-924-3262
Mailing Address - Fax:417-924-1344
Practice Address - Street 1:104 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:MO
Practice Address - Zip Code:65704-9526
Practice Address - Country:US
Practice Address - Phone:417-924-3262
Practice Address - Fax:417-924-1344
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010015973122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist