Provider Demographics
NPI:1619008638
Name:CALDWELL, DARIN WAYNE (DMD)
Entity Type:Individual
Prefix:DR
First Name:DARIN
Middle Name:WAYNE
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 EAGLE ROCK DR
Mailing Address - Street 2:
Mailing Address - City:CLANCY
Mailing Address - State:MT
Mailing Address - Zip Code:59634-9627
Mailing Address - Country:US
Mailing Address - Phone:406-442-6346
Mailing Address - Fax:
Practice Address - Street 1:2615 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4910
Practice Address - Country:US
Practice Address - Phone:406-443-2334
Practice Address - Fax:406-443-2332
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT20601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice