Organization
DANIELLE S. EZELL, DMD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIELLE SUZETTE EZELL DMD (DENTIST/OWNER)
(803) 684-6545
Entity
Organization
Contact information
Practice address
9 W MADISON ST, YORK, SC 29745-1143
(803) 684-6545
(803) 684-0239
Mailing address
PO BOX 395, YORK, SC 29745-0395
(803) 684-6545
(803) 684-0239
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4367
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX4367
—
SC
Enumeration date
06/30/2009
Last updated
06/30/2009
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