Brent Danielson, DDS

NPI #1174848576 in La Grange, Illinois

Provider Information

NPI Number
1174848576
Entity Type
Individual
Name
Brent Danielson, DDS
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dentist - General Practice
Credential
DDS
Enumeration Date
Mar 29, 2010
Last Updated
Mar 29, 2010

Practice Location

Address
1400 W 47TH ST
ZIP Code
60525-6141
Phone
(708) 482-4420

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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