Provider Demographics
NPI:1871501536
Name:FORD, DARIN WADE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARIN
Middle Name:WADE
Last Name:FORD
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 397
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28106-0397
Mailing Address - Country:US
Mailing Address - Phone:704-847-9858
Mailing Address - Fax:704-841-9095
Practice Address - Street 1:452 MATTHEWS MINT HILL RD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-2793
Practice Address - Country:US
Practice Address - Phone:704-847-9858
Practice Address - Fax:704-841-9095
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNL63051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice