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General NPI Number Information
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NPI Number | 1952789901
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Entity Type | Organization
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Legal Business Name | JOEL W. DARRAH, DDS, PC
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Dates
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Enumeration Date | 05/11/2015
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Last Update Date | 05/11/2015
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Provider Practice Location Address
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Address Line | 31 INNOVATION DR
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City | BLUFFTON
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State | SC
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Zip | 29910-5159
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Country | US
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Telephone | 614-394-4233
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Fax |
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Provider Business Mailing Address
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Address Line | 109 SILVER CREST DR
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City | COLUMBIA
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State | SC
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Zip | 29223-2915
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Country | US
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Telephone | 614-394-4233
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. JOEL WALKER DARRAH
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Credential | D.D.S
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Telephone | 614-394-4233
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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 | 4518
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License Number State | SC
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