Basic Information
| Provider Information | |||||||||
| NPI: | 1306243043 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DARRELL G. DAY, DDS PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4501 MATLOCK RD | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760181004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8174720888 | ||||||||
| FaxNumber: | 8174729753 | ||||||||
| Practice Location | |||||||||
| Address1: | 4501 MATLOCK RD | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760181004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8174720888 | ||||||||
| FaxNumber: | 8174729753 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/24/2014 | ||||||||
| LastUpdateDate: | 11/24/2014 | ||||||||
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| AuthorizedOfficialLastName: | DAY | ||||||||
| AuthorizedOfficialFirstName: | DARRELL | ||||||||
| AuthorizedOfficialMiddleName: | G | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER / DENTIST | ||||||||
| AuthorizedOfficialTelephone: | 8174720888 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DDS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 20868 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Dental Providers | Dentist | General Practice |
No ID Information.