Provider Demographics
NPI:1952789901
Name:JOEL W. DARRAH, DDS, PC
Entity Type:Organization
Organization Name:JOEL W. DARRAH, DDS, PC
Other - Org Name:BUCKWALTER DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:WALKER
Authorized Official - Last Name:DARRAH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-394-4233
Mailing Address - Street 1:109 SILVER CREST DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-2915
Mailing Address - Country:US
Mailing Address - Phone:614-394-4233
Mailing Address - Fax:
Practice Address - Street 1:31 INNOVATION DR
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-5159
Practice Address - Country:US
Practice Address - Phone:614-394-4233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4518122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty