Healthcare Provider Details

I. General information

NPI: 1881065225
Provider Name (Legal Business Name): DARIN L. EDEEN, DDS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2015
Last Update Date: 10/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 CENTER AVE W
DILWORTH MN
56529-1339
US

IV. Provider business mailing address

802 CENTER AVE W
DILWORTH MN
56529-1339
US

V. Phone/Fax

Practice location:
  • Phone: 218-287-2938
  • Fax: 218-287-0317
Mailing address:
  • Phone: 218-287-2938
  • Fax: 218-287-0317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. DARIN L. EDEEN
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 218-287-2938