Provider Demographics
NPI:1124141973
Name:DANIELS, WILLIAM WAYNER (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:WAYNER
Last Name:DANIELS
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 1:303 A EAST UNIVERSITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840
Mailing Address - Country:US
Mailing Address - Phone:979-846-7016
Mailing Address - Fax:979-691-2342
Practice Address - Street 1:303 A EAST UNIVERSITY DRIVE
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840
Practice Address - Country:US
Practice Address - Phone:979-846-7016
Practice Address - Fax:979-691-2342
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX176981223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics