Provider Demographics
NPI:1447416680
Name:RON DARDEN DDS & BRYCE DARDEN DDS
Entity type:Organization
Organization Name:RON DARDEN DDS & BRYCE DARDEN DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYCE
Authorized Official - Middle Name:MASON
Authorized Official - Last Name:DARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-963-6006
Mailing Address - Street 1:175 N PENNSYLVANIA AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-3316
Mailing Address - Country:US
Mailing Address - Phone:626-963-6006
Mailing Address - Fax:626-963-1235
Practice Address - Street 1:175 N PENNSYLVANIA AVE
Practice Address - Street 2:STE 1
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-3316
Practice Address - Country:US
Practice Address - Phone:626-963-6006
Practice Address - Fax:626-963-1235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty