Connelly, Daniel Ray

Connelly, Daniel Ray is an individual health care provider with primary practice located at 5429 Secor Rd , Toledo OH 43623-1930. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Connelly, Daniel Ray can be contacted via phone (419) 474-3411.

Contact Information

Primary practice address
5429 Secor Rd Toledo OH 43623-1930
Fax: (419) 474-3456
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 18357 Ohio

Profile Details

NPI number 1700873353
LBN Legal business name Connelly, Daniel Ray
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2005
Last updated Jul 8th, 2007 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700873353 NPPES
Ohio MEDICAID 0823569

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