Provider Demographics
NPI:1841274297
Name:SURH, DANIEL D (DMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:D
Last Name:SURH
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 1:2477 FOREST AVE STE 170
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-7684
Mailing Address - Country:US
Mailing Address - Phone:530-636-4943
Mailing Address - Fax:530-636-4301
Practice Address - Street 1:2477 FOREST AVE STE 170
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-7684
Practice Address - Country:US
Practice Address - Phone:530-636-4943
Practice Address - Fax:530-636-4301
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS035871122300000X
CA56562122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist