Healthcare Provider Details
I. General information
NPI: 1942088059
Provider Name (Legal Business Name): DARIN ERROLL TOWNSEND II DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/19/2023
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
767 VETERANS PKWY
HINESVILLE GA
31313-3950
US
IV. Provider business mailing address
PO BOX 2422
HINESVILLE GA
31310-7422
US
V. Phone/Fax
- Phone: 912-877-6453
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | DN123260 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: