Provider Demographics
NPI:1245421650
Name:DARRIN CUPO DMD PA
Entity Type:Organization
Organization Name:DARRIN CUPO DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CUPO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD PA
Authorized Official - Phone:305-278-9914
Mailing Address - Street 1:19489 SOUTH DIXIE HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7600
Mailing Address - Country:US
Mailing Address - Phone:305-278-9914
Mailing Address - Fax:305-278-9917
Practice Address - Street 1:19489 SOUTH DIXIE HIGHWAY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-7600
Practice Address - Country:US
Practice Address - Phone:305-278-9914
Practice Address - Fax:305-278-9917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDN130061223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty