Provider Demographics
NPI:1083842611
Name:BRYAN DARLING, DDS, MD, PA
Entity Type:Organization
Organization Name:BRYAN DARLING, DDS, MD, PA
Other - Org Name:THE ORAL & IMPLANT SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:DARLING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:870-933-1221
Mailing Address - Street 1:317 SOUTHWEST DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401
Mailing Address - Country:US
Mailing Address - Phone:870-933-1221
Mailing Address - Fax:
Practice Address - Street 1:317 SOUTHWEST DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401
Practice Address - Country:US
Practice Address - Phone:870-933-1221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3640261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery