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General NPI Number Information
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NPI Number | 1558546564
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Entity Type | Organization
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Legal Business Name | DARR DENTAL LLC
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 01/09/2008
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Provider Practice Location Address
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Address Line | 9A RICHARDSON AVE
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City | WAKEFIELD
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State | MA
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Zip | 01880-2912
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Country | US
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Telephone | 781-245-2030
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Fax |
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Provider Business Mailing Address
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Address Line | 9A RICHARDSON AVE
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City | WAKEFIELD
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State | MA
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Zip | 01880-2912
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER/DENTIST
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Name | DEAN DARR
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Credential |
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Telephone | 781-245-2030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 17451
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License Number State | MA
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