Provider Demographics
NPI:1154403053
Name:SQUILLA, DANIEL FRANK (DDS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:FRANK
Last Name:SQUILLA
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 1:399 SENECA PARKWAY
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14613
Mailing Address - Country:US
Mailing Address - Phone:585-458-3544
Mailing Address - Fax:
Practice Address - Street 1:399 SENECA PARKWAY
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14613
Practice Address - Country:US
Practice Address - Phone:585-458-3544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0405651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice