Provider Demographics
NPI:1861752313
Name:MCALLISTER, DANIEL JEROME (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JEROME
Last Name:MCALLISTER
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 1:3 SUNSET PLZ
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3660
Mailing Address - Country:US
Mailing Address - Phone:406-752-1166
Mailing Address - Fax:
Practice Address - Street 1:3 SUNSET PLZ
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3660
Practice Address - Country:US
Practice Address - Phone:406-752-1166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-17
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT41651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice