Provider Demographics
NPI:1881065225
Name:DARIN L. EDEEN, DDS, PC
Entity type:Organization
Organization Name:DARIN L. EDEEN, DDS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DARIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:EDEEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:218-287-2938
Mailing Address - Street 1:802 CENTER AVE W
Mailing Address - Street 2:
Mailing Address - City:DILWORTH
Mailing Address - State:MN
Mailing Address - Zip Code:56529-1339
Mailing Address - Country:US
Mailing Address - Phone:218-287-2938
Mailing Address - Fax:218-287-0317
Practice Address - Street 1:802 CENTER AVE W
Practice Address - Street 2:
Practice Address - City:DILWORTH
Practice Address - State:MN
Practice Address - Zip Code:56529-1339
Practice Address - Country:US
Practice Address - Phone:218-287-2938
Practice Address - Fax:218-287-0317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty