Provider Demographics
NPI:1427256296
Name:BARRILLEAUX, DARREN PATRICK (DDS)
Entity type:Individual
Prefix:
First Name:DARREN
Middle Name:PATRICK
Last Name:BARRILLEAUX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11093 ALABAMA HWY 71
Mailing Address - Street 2:
Mailing Address - City:PISGAH
Mailing Address - State:AL
Mailing Address - Zip Code:35765-7713
Mailing Address - Country:US
Mailing Address - Phone:256-451-7242
Mailing Address - Fax:256-451-3032
Practice Address - Street 1:11093 ALABAMA HWY 71
Practice Address - Street 2:
Practice Address - City:PISGAH
Practice Address - State:AL
Practice Address - Zip Code:35765-7713
Practice Address - Country:US
Practice Address - Phone:256-451-7242
Practice Address - Fax:256-451-3032
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4490122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist