Provider Demographics
NPI:1306243043
Name:DARRELL G. DAY, DDS PA
Entity type:Organization
Organization Name:DARRELL G. DAY, DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:G
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-472-0888
Mailing Address - Street 1:4501 MATLOCK RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-1004
Mailing Address - Country:US
Mailing Address - Phone:817-472-0888
Mailing Address - Fax:817-472-9753
Practice Address - Street 1:4501 MATLOCK RD
Practice Address - Street 2:SUITE 301
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-1004
Practice Address - Country:US
Practice Address - Phone:817-472-0888
Practice Address - Fax:817-472-9753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty