Provider Demographics
NPI:1104930080
Name:DAILY, DIO L (DDS)
Entity type:Individual
Prefix:DR
First Name:DIO
Middle Name:L
Last Name:DAILY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 S GLENSTONE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SPRINGSFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-3714
Mailing Address - Country:US
Mailing Address - Phone:417-883-5212
Mailing Address - Fax:417-883-1028
Practice Address - Street 1:2740 S GLENSTONE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SPRINGSFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-3714
Practice Address - Country:US
Practice Address - Phone:417-883-5212
Practice Address - Fax:417-883-1028
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO11394122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist