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General NPI Number Information
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NPI Number | 1740979319
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Entity Type | Organization
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Legal Business Name | SHAUN DARRAH PEDIATRIC DENTISTRY PLLC
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Dates
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Enumeration Date | 05/01/2023
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 1133 WARBURTON AVE APT. 604 N.
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City | YONKERS
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State | NY
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Zip | 10701
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Country | US
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Telephone | 631-398-9376
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Fax |
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Provider Business Mailing Address
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Address Line | 1133 WARBURTON AVE APT. 604 N.
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City | YONKERS
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State | NY
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Zip | 10701
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Country | US
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Telephone | 631-398-9376
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC DENTIST-OWNER
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Name | SHAUN FREDERICK DARRAH
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Credential | D.D.S.
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Telephone | 631-398-9376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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