Provider Demographics
NPI:1225288202
Name:LIND, DARON J (DDS)
Entity Type:Individual
Prefix:
First Name:DARON
Middle Name:J
Last Name:LIND
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 1:2320 E GALA ST
Mailing Address - Street 2:STE 200
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-7091
Mailing Address - Country:US
Mailing Address - Phone:208-846-8847
Mailing Address - Fax:208-288-2786
Practice Address - Street 1:2320 E GALA ST
Practice Address - Street 2:STE 200
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-7091
Practice Address - Country:US
Practice Address - Phone:208-846-8847
Practice Address - Fax:208-288-2786
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-41891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice