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Individual

DANIEL L DALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1525 PARK PLACE, GREEN BAY, WI 54304-1979
(920) 965-1234
(920) 965-1232
Mailing address
1525 PARK PLACE, GREEN BAY, WI 54304-1979
(920) 965-1234
(920) 965-1232

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
30832
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
161633405011
BCBS
05
3167500
WI
01
5966510002
MEDICARE NCS
WI
Enumeration date
06/13/2005
Last updated
01/26/2010
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