Healthcare Provider Details

I. General information

NPI: 1598755845
Provider Name (Legal Business Name): DAVID JOHN DARAB DDS MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3452 GRAYSTONE PLACE SE
HICKORY NC
28601
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:
Title or Position:
Credential:
Phone: