Individual
DR. BRIAN LORY DANIELSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
700 N SANDERS ST, SUITE A, RIDGECREST, CA 93555-3528
(760) 371-4800
(760) 371-4825
Mailing address
700 N SANDERS ST, SUITE A, RIDGECREST, CA 93555-3528
(760) 371-4800
(760) 371-4825
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
35243
CA
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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