Provider Demographics
NPI:1518997592
Name:BLEY, DANIEL JAMES (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JAMES
Last Name:BLEY
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 1:2 CENTER PLZ
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02108-1909
Mailing Address - Country:US
Mailing Address - Phone:617-227-8536
Mailing Address - Fax:617-227-7254
Practice Address - Street 1:2 CENTER PLZ
Practice Address - Street 2:SUITE 100
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108-1909
Practice Address - Country:US
Practice Address - Phone:617-227-8536
Practice Address - Fax:617-227-7254
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19196122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist