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Provider Information for 1033255062

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Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. KEVIN JOHN DAILY D.D.S.

Gender: MALE

Individual NPI: 1033255062

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1033255062
Enumeration Date 2007-01-29
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 4100 PORTOLA DR STE. #4
SANTA CRUZ, CA 95062-4500
United States

Phone: 831-476-4100 | Fax: 831-476-4266
View Map External Link
Primary Practice Address 4100 PORTOLA DR STE. #4
SANTA CRUZ, CA 95062-4500
United States

Phone: 831-476-4100 | Fax: 831-476-4266
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice CA 39251