Provider Demographics
NPI:1447423702
Name:DARLING, SALLY KAY (DDS)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:KAY
Last Name:DARLING
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4706 BANNING AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110-3216
Mailing Address - Country:US
Mailing Address - Phone:651-429-3348
Mailing Address - Fax:651-429-3945
Practice Address - Street 1:4706 BANNING AVE
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-3216
Practice Address - Country:US
Practice Address - Phone:651-429-3348
Practice Address - Fax:651-429-3945
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN92531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice