Healthcare Provider Details

I. General information

NPI: 1841340049
Provider Name (Legal Business Name): DRS. DARAB AND RICHARDSON, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3452 GRAYSTONE PL
CONOVER NC
28613-8200
US

IV. Provider business mailing address

PO BOX 2526
HICKORY NC
28603-2526
US

V. Phone/Fax

Practice location:
  • Phone: 828-322-1667
  • Fax: 828-485-3208
Mailing address:
  • Phone: 828-322-1667
  • Fax: 828-485-3208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number5386
License Number StateNC

VIII. Authorized Official

Name: DR. DAVID JOHN DARAB
Title or Position: PRESIDENT
Credential: DDS, MS
Phone: 828-322-1667