Provider Demographics
NPI:1902950579
Name:SALVATORE, DANIEL WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:WILLIAM
Last Name:SALVATORE
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 1:500 FOX GLN
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-1833
Mailing Address - Country:US
Mailing Address - Phone:847-277-9800
Mailing Address - Fax:847-852-1019
Practice Address - Street 1:500 FOX GLN
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-1833
Practice Address - Country:US
Practice Address - Phone:847-277-9800
Practice Address - Fax:847-852-1019
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice