Provider Demographics
NPI:1760446900
Name:OWENS, DARREN A (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARREN
Middle Name:A
Last Name:OWENS
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 1:1000 MAIN ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-2978
Mailing Address - Country:US
Mailing Address - Phone:770-469-1331
Mailing Address - Fax:
Practice Address - Street 1:105 HIGHLAND AVE.
Practice Address - Street 2:
Practice Address - City:CORNELIA
Practice Address - State:GA
Practice Address - Zip Code:30531
Practice Address - Country:US
Practice Address - Phone:706-778-8645
Practice Address - Fax:706-776-2650
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0121301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice