Healthcare Provider Details

I. General information

NPI: 1639284375
Provider Name (Legal Business Name): DARIN CHRISTOPHER LEE D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 08/11/2020
Certification Date: 08/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 MAIN ST STE 303A
EDWARDS CO
81632-8109
US

IV. Provider business mailing address

PO BOX 2961
EDWARDS CO
81632
US

V. Phone/Fax

Practice location:
  • Phone: 970-748-6961
  • Fax: 970-845-2201
Mailing address:
  • Phone: 970-748-6961
  • Fax: 970-845-2201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number9144
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: