Provider Demographics
NPI:1508039553
Name:DARBY, DAVID A (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:DARBY
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:PO BOX 470
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-0470
Mailing Address - Country:US
Mailing Address - Phone:810-229-7034
Mailing Address - Fax:
Practice Address - Street 1:225 E GRAND RIVER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-1586
Practice Address - Country:US
Practice Address - Phone:810-229-7034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI088191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice