# DANIEL DAFO,DDS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861800591
- **Authorized official:** DR. DANIEL DAFO DDS (PRACTICE OWNER)
- **Authorized official phone:** (304) 295-8256

## Contact information

- **Practice address:** 1500 GRAND CENTRAL AVE, SUITE 104, VIENNA, WV 26105-1079
- **Practice address phone:** (304) 295-8256
- **Practice address fax:** (304) 295-8261
- **Mailing address:** 1500 GRAND CENTRAL AVE, SUITE 104, VIENNA, WV 26105-1079
- **Mailing address phone:** (304) 295-8256
- **Mailing address fax:** (304) 295-8261

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 4038 | WV | Yes |

## Other

- **Enumeration date:** 07/25/2014
- **Last updated:** 07/25/2014