Provider Demographics
NPI:1366700742
Name:EINERSON, DANIEL PAUL (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PAUL
Last Name:EINERSON
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 1:300 22ND AVE E
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-4833
Mailing Address - Country:US
Mailing Address - Phone:320-763-3445
Mailing Address - Fax:320-763-5994
Practice Address - Street 1:300 22ND AVE E
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-4833
Practice Address - Country:US
Practice Address - Phone:320-763-3445
Practice Address - Fax:320-763-5994
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-24
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13281122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist