Provider Demographics
NPI:1184649568
Name:RAGLAND, DARRYL KEVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARRYL
Middle Name:KEVIN
Last Name:RAGLAND
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 1:2237 PARK TOWNE CIR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-0417
Mailing Address - Country:US
Mailing Address - Phone:916-483-6161
Mailing Address - Fax:916-367-6725
Practice Address - Street 1:2237 PARK TOWNE CIR
Practice Address - Street 2:SUITE 3
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-0417
Practice Address - Country:US
Practice Address - Phone:916-483-6161
Practice Address - Fax:916-367-6725
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4753122300000X
CA35973122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist