Provider Demographics
NPI:1902160849
Name:MESSERSCHMIDT, DANIEL LEE (DDS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:LEE
Last Name:MESSERSCHMIDT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:DANIEL
Other - Middle Name:LEE
Other - Last Name:MESSERSCHMIDT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1870 PRICE DR
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23970
Mailing Address - Country:US
Mailing Address - Phone:434-390-0490
Mailing Address - Fax:434-696-2045
Practice Address - Street 1:690 FALLS RD
Practice Address - Street 2:
Practice Address - City:VICTORIRA
Practice Address - State:VA
Practice Address - Zip Code:23974
Practice Address - Country:US
Practice Address - Phone:434-696-2045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401006805122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist