Individual
DR. THEO JAMAL DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
15990 S BRADLEY DR, OLATHE, KS 66062-3925
(913) 390-5300
Mailing address
15990 S BRADLEY DR, OLATHE, KS 66062-3925
(913) 390-5300
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
61651
KS
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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