Provider Demographics
NPI:1164635074
Name:DAILY & ROSEN, D.D.S., L.L.C.
Entity type:Organization
Organization Name:DAILY & ROSEN, D.D.S., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIO
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAILY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:417-883-5212
Mailing Address - Street 1:2740 S GLENSTONE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-3714
Mailing Address - Country:US
Mailing Address - Phone:417-883-5212
Mailing Address - Fax:417-883-1028
Practice Address - Street 1:2740 S GLENSTONE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-3714
Practice Address - Country:US
Practice Address - Phone:417-883-5212
Practice Address - Fax:417-883-1028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO113941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty