Provider Demographics
NPI:1225111867
Name:CLINE, DARRELL EUGENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:EUGENE
Last Name:CLINE
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 1:4112 HARBOUR POINTE BLVD SW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275
Mailing Address - Country:US
Mailing Address - Phone:425-493-1300
Mailing Address - Fax:425-493-9720
Practice Address - Street 1:4112 HARBOUR POINTE BLVD SW
Practice Address - Street 2:SUITE 200
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275
Practice Address - Country:US
Practice Address - Phone:425-493-1300
Practice Address - Fax:425-493-9720
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA63141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice