Provider Demographics
NPI:1861713786
Name:DALY, AUSTIN PATRICK (MD, DDS)
Entity type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:PATRICK
Last Name:DALY
Suffix:
Gender:M
Credentials:MD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 LAKESIDE PARK OFC PARK
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-4048
Mailing Address - Country:US
Mailing Address - Phone:215-938-7860
Mailing Address - Fax:215-857-8189
Practice Address - Street 1:1650 HUNTINGDON PIKE STE 219
Practice Address - Street 2:
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046-8006
Practice Address - Country:US
Practice Address - Phone:215-938-7860
Practice Address - Fax:215-857-8189
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0406401223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery