Individual
DR. MICHAEL DAVID MCDANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.P.A.
Contact information
Practice address
501 PARK AVE, INDIANOLA, MS 38751-2355
(662) 887-1272
(662) 887-6453
Mailing address
PO BOX 972, 501 PARK AVENUE, INDIANOLA, MS 38751-0972
(662) 887-1272
(662) 887-6453
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
273893
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660041
—
MS
Enumeration date
09/27/2006
Last updated
07/09/2007
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