Provider Demographics
NPI:1740584036
Name:DARIN TOWNSEND FAMILY DENTAL CENTER, LLC
Entity Type:Organization
Organization Name:DARIN TOWNSEND FAMILY DENTAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DARIN
Authorized Official - Middle Name:ERROLL
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:912-256-0005
Mailing Address - Street 1:218 SANDPIPER DR
Mailing Address - Street 2:
Mailing Address - City:MIDWAY
Mailing Address - State:GA
Mailing Address - Zip Code:31320-2505
Mailing Address - Country:US
Mailing Address - Phone:912-256-0005
Mailing Address - Fax:
Practice Address - Street 1:767 FRANK COCHRAN DR
Practice Address - Street 2:SUITE 102
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-3950
Practice Address - Country:US
Practice Address - Phone:912-877-6453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-31
Last Update Date:2010-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGADN012222122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty