Provider Demographics
NPI:1699864934
Name:WEST, DANIEL C (DMD MAGD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:C
Last Name:WEST
Suffix:
Gender:M
Credentials:DMD MAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:NEW HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17557
Mailing Address - Country:US
Mailing Address - Phone:717-354-3200
Mailing Address - Fax:717-354-8005
Practice Address - Street 1:650 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:NEW HOLLAND
Practice Address - State:PA
Practice Address - Zip Code:17557
Practice Address - Country:US
Practice Address - Phone:717-354-3200
Practice Address - Fax:717-354-8005
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS022883L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA129364OtherUNITED CONCORDIA
PA022883OtherDELTA