Provider Demographics
NPI:1841203049
Name:THIRLWALL, DANIELS CONNOP (DMD)
Entity type:Individual
Prefix:DR
First Name:DANIELS
Middle Name:CONNOP
Last Name:THIRLWALL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1771 W ROMNEYA
Mailing Address - Street 2:#F
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801
Mailing Address - Country:US
Mailing Address - Phone:714-999-8840
Mailing Address - Fax:714-999-8846
Practice Address - Street 1:1771 W ROMNEYA
Practice Address - Street 2:#F
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801
Practice Address - Country:US
Practice Address - Phone:714-999-8840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA238751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice