Provider Demographics
NPI:1730376427
Name:DANIELI, ANNA AGNIESZKA (DDS)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:AGNIESZKA
Last Name:DANIELI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 S PUGET DR STE 102
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-4404
Mailing Address - Country:US
Mailing Address - Phone:425-228-1521
Mailing Address - Fax:425-228-0380
Practice Address - Street 1:1900 S PUGET DR STE 102
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-4404
Practice Address - Country:US
Practice Address - Phone:425-228-1521
Practice Address - Fax:425-228-0380
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00008209122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist