Provider Demographics
NPI:1144667080
Name:DAULTON, IAN JOSEPH (DDS)
Entity type:Individual
Prefix:
First Name:IAN
Middle Name:JOSEPH
Last Name:DAULTON
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 1:1395 CENTER DR ROOM # D2-27 UNIVERSITY OF FLORIDA
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0001
Mailing Address - Country:US
Mailing Address - Phone:352-273-7957
Mailing Address - Fax:352-846-1643
Practice Address - Street 1:1395 CENTER DR ROOM # D2-27 UNIVERSITY OF FLORIDA
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0001
Practice Address - Country:US
Practice Address - Phone:352-273-7957
Practice Address - Fax:352-846-1643
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-02
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDRPM2509122300000X
TX288881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice