Provider Demographics
NPI:1205678778
Name:DARCY, FREDERICK ROBERT (DMD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:ROBERT
Last Name:DARCY
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 1:113 PETTICOAT LN
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NJ
Mailing Address - Zip Code:08833-4109
Mailing Address - Country:US
Mailing Address - Phone:908-310-0732
Mailing Address - Fax:
Practice Address - Street 1:87 BEAVER AVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809-1085
Practice Address - Country:US
Practice Address - Phone:908-437-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI03039400122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist