Provider Demographics
NPI:1659755320
Name:DALTON, DAVID A (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:DALTON
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-2650
Mailing Address - Country:US
Mailing Address - Phone:435-708-1955
Mailing Address - Fax:816-718-3751
Practice Address - Street 1:137 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-2650
Practice Address - Country:US
Practice Address - Phone:435-708-1955
Practice Address - Fax:816-718-3751
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11377208-1204204D00000X, 207Q00000X
NVDO2594204D00000X, 207Q00000X
AZ011122207Q00000X
CA20A23406207Q00000X
MO2015020391207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty