Individual
MRS. CHASTITY DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH, RN
Contact information
Practice address
851 S LYONS AVE, TYLER, TX 75701-1222
(903) 330-9531
Mailing address
13362 GARDEN LAKE RD, TYLER, TX 75703-6515
(903) 330-9531
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
12305
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12305
DENTAL HYGIENE
TX
Enumeration date
02/02/2023
Last updated
02/02/2023
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