Provider Demographics
NPI:1932230919
Name:TWILLMANN, DANIEL D (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:D
Last Name:TWILLMANN
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 1:5 WINDCASTLE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-0443
Mailing Address - Country:US
Mailing Address - Phone:636-244-3030
Mailing Address - Fax:
Practice Address - Street 1:1185 CAVE SPRINGS ESTATE DR
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-6529
Practice Address - Country:US
Practice Address - Phone:636-757-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO138021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice