Provider Demographics
NPI:1184613390
Name:HOVLAND, DARREN EUGENE (DDS)
Entity type:Individual
Prefix:DR
First Name:DARREN
Middle Name:EUGENE
Last Name:HOVLAND
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 1:1304 W MEDICINE LAKE DR
Mailing Address - Street 2:#203
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-4860
Mailing Address - Country:US
Mailing Address - Phone:763-546-0177
Mailing Address - Fax:
Practice Address - Street 1:1025 EVERGREEN LN N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-4800
Practice Address - Country:US
Practice Address - Phone:763-546-2209
Practice Address - Fax:763-546-9107
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN111821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice