Provider Demographics
NPI:1811074198
Name:DARLING, NATHAN (DDS)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:DARLING
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 1:7161 N PORT WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-3877
Mailing Address - Country:US
Mailing Address - Phone:414-247-1470
Mailing Address - Fax:414-247-1490
Practice Address - Street 1:7161 N PORT WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53217-3877
Practice Address - Country:US
Practice Address - Phone:414-247-1470
Practice Address - Fax:414-247-1490
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI53951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice