Provider Demographics
NPI:1124176763
Name:MCCALL, DANIEL LEO (DMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:LEO
Last Name:MCCALL
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 1:14 WINN ST
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-2829
Mailing Address - Country:US
Mailing Address - Phone:781-933-2551
Mailing Address - Fax:781-933-0548
Practice Address - Street 1:14 WINN ST
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-2829
Practice Address - Country:US
Practice Address - Phone:781-933-2551
Practice Address - Fax:781-933-0548
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18344122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist