Robert Michael Daly, D.D.S.

Individual provider Active NPI General Practice Dentistry · Gambrills, MD

NPI 1174733844 · NPPES record last updated Dec 7, 2015

Key facts

NPI
1174733844
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
12201 (MD)
Practice address
2391 Brandermill Blvd
102
Gambrills, MD 21054-1847
Phone
(410) 452-9600
Fax
(410) 452-9770
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
12201MDMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12201 MD Yes

Addresses

Primary practice location

2391 Brandermill Blvd
102
Gambrills, MD 21054-1847

Mailing address

2391 Brandermill Blvd
102
Gambrills, MD 21054-1847
Phone (410) 451-9600

Other providers in Gambrills, MD

All providers in Gambrills, MD · General Practice Dentistry in Maryland

Sources for this page

Verify at the official NPI Registry.