Provider Demographics
NPI:1366518094
Name:DAHSE, BYRON PAUL (DDS)
Entity type:Individual
Prefix:
First Name:BYRON
Middle Name:PAUL
Last Name:DAHSE
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 1:715 HILL COUNTRY DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028
Mailing Address - Country:US
Mailing Address - Phone:830-257-7118
Mailing Address - Fax:830-257-7120
Practice Address - Street 1:715 HILL COUNTRY DR
Practice Address - Street 2:SUITE 2
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028
Practice Address - Country:US
Practice Address - Phone:830-257-7118
Practice Address - Fax:830-257-7120
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice