Provider Demographics
NPI:1811426406
Name:DALY, IVETTE LANDRIAN (DDS)
Entity type:Individual
Prefix:DR
First Name:IVETTE
Middle Name:LANDRIAN
Last Name:DALY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:IVETTE
Other - Middle Name:
Other - Last Name:LANDRIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:1126 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1000
Mailing Address - Country:US
Mailing Address - Phone:954-547-8409
Mailing Address - Fax:
Practice Address - Street 1:3814 RURAL RETREAT ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215
Practice Address - Country:US
Practice Address - Phone:336-265-7212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC106431223G0001X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice