Provider Demographics
NPI:1326378910
Name:WESTON, DANLY PRESTON (DDS)
Entity type:Individual
Prefix:DR
First Name:DANLY
Middle Name:PRESTON
Last Name:WESTON
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:PO BOX 441031
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20749-1031
Mailing Address - Country:US
Mailing Address - Phone:301-509-9269
Mailing Address - Fax:
Practice Address - Street 1:1004 WHITE OAK DR
Practice Address - Street 2:SUITE 1
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-1739
Practice Address - Country:US
Practice Address - Phone:301-839-9269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD096451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice