Provider Demographics
NPI:1912106816
Name:BYRD, DARYL
Entity Type:Individual
Prefix:DR
First Name:DARYL
Middle Name:
Last Name:BYRD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1932 ALMAVILLE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-7600
Mailing Address - Country:US
Mailing Address - Phone:615-209-8500
Mailing Address - Fax:
Practice Address - Street 1:1932 ALMAVILLE RD STE 105
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-7600
Practice Address - Country:US
Practice Address - Phone:615-209-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8460122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist