Provider Demographics
NPI:1174611610
Name:DONOHUE, DANIEL E (DDS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:DONOHUE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1858 KELLER PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-3757
Mailing Address - Country:US
Mailing Address - Phone:817-431-6008
Mailing Address - Fax:817-337-0098
Practice Address - Street 1:1858 KELLER PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3757
Practice Address - Country:US
Practice Address - Phone:817-431-6008
Practice Address - Fax:817-337-0098
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX149211223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry