Healthcare Provider Details

I. General information

NPI: 1467572412
Provider Name (Legal Business Name): DARCY LYNN OWEN D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 02/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7916 PEBBLE BEACH DR SUITE 101
CITRUS HEIGHTS CA
95610-7790
US

IV. Provider business mailing address

1509 SHERWOOD AVE
SACRAMENTO CA
95822-1242
US

V. Phone/Fax

Practice location:
  • Phone: 916-962-0577
  • Fax:
Mailing address:
  • Phone: 916-529-6473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number47402
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: