Provider Demographics
NPI:1992924351
Name:ROLAND, DANIEL RAY (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:RAY
Last Name:ROLAND
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 1:115 GRANDE BLVD
Mailing Address - Street 2:
Mailing Address - City:SINKING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-9679
Mailing Address - Country:US
Mailing Address - Phone:610-678-6490
Mailing Address - Fax:
Practice Address - Street 1:40 BERKSHIRE CT
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1224
Practice Address - Country:US
Practice Address - Phone:610-374-4524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0206501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice