Provider Demographics
NPI:1316256712
Name:DAILLEY, ANTHONY MURRAY (DDS)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:MURRAY
Last Name:DAILLEY
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 1:2999 REGENT ST STE 3023
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2190
Mailing Address - Country:US
Mailing Address - Phone:510-848-0114
Mailing Address - Fax:
Practice Address - Street 1:2999 REGENT ST STE 302
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2118
Practice Address - Country:US
Practice Address - Phone:510-848-0114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-02
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29807122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist