Provider Demographics
NPI:1902042302
Name:DURCHSLAG, DANIEL GERALD (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:GERALD
Last Name:DURCHSLAG
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 1:24622 CORDERA CT
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2042
Mailing Address - Country:US
Mailing Address - Phone:661-373-9190
Mailing Address - Fax:
Practice Address - Street 1:24250 TOWN CENTER DR STE 160
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-4473
Practice Address - Country:US
Practice Address - Phone:661-259-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26052122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist