Healthcare Provider Details

I. General information

NPI: 1184799033
Provider Name (Legal Business Name): DARIN ERROLL TOWNSEND DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 09/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

767 FRANK COCHRAN DR SUITE 102
HINESVILLE GA
31313-3950
US

IV. Provider business mailing address

767 FRANK COCHRAN DR SUITE 102
HINESVILLE GA
31313-3950
US

V. Phone/Fax

Practice location:
  • Phone: 912-877-6453
  • Fax: 912-877-5800
Mailing address:
  • Phone: 912-877-6453
  • Fax: 912-877-5800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN 012222
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: