Individual
DR. SETH THOMAS DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
216 S CENTER ST, GENESEO, IL 61254-1402
(309) 502-9404
Mailing address
216 S CENTER ST, GENESEO, IL 61254-1402
(309) 944-6125
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.032690
IL
Other
Enumeration date
06/19/2020
Last updated
06/19/2020
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