Provider Demographics
NPI:1164592226
Name:FOSTER, DARREN G (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARREN
Middle Name:G
Last Name:FOSTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 GALLATIN PIKE N
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-3701
Mailing Address - Country:US
Mailing Address - Phone:615-868-6177
Mailing Address - Fax:615-868-8863
Practice Address - Street 1:117 GALLATIN PIKE N
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-3701
Practice Address - Country:US
Practice Address - Phone:615-868-6177
Practice Address - Fax:615-868-8863
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000079101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice