Dale, Daniel L

Dale, Daniel L is an sole proprietor health care provider with primary practice located at 1525 Park Place , Green Bay WI 54304-1979. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Dale, Daniel L can be contacted via phone (920) 965-1234.

Contact Information

Primary practice address
1525 Park Place Green Bay WI 54304-1979
Phone: (920) 965-1234
Fax: (920) 965-1232
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 30832 Wisconsin

Profile Details

NPI number 1326042730
LBN Legal business name Dale, Daniel L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 13th, 2005
Last updated Jan 26th, 2010 - about 16 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 1326042730 NPPES
Wisconsin MEDICAID 3167500
Wisconsin Other 5966510002
Wisconsin Other 161633405011

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