Provider Demographics
NPI:1033164116
Name:WAKEFIELD DOWER, DARCY A (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARCY
Middle Name:A
Last Name:WAKEFIELD DOWER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:DARCY
Other - Middle Name:
Other - Last Name:WAKEFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:951 STEUBENVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-2371
Mailing Address - Country:US
Mailing Address - Phone:740-435-3100
Mailing Address - Fax:
Practice Address - Street 1:951 STEUBENVILLE AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725
Practice Address - Country:US
Practice Address - Phone:740-435-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH219621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2527653Medicaid