Provider Demographics
NPI:1598856957
Name:MACHULE, DARREN (DMD PHD)
Entity type:Individual
Prefix:
First Name:DARREN
Middle Name:
Last Name:MACHULE
Suffix:
Gender:M
Credentials:DMD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 POST STREET
Mailing Address - Street 2:SUITE 1516
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-1302
Mailing Address - Country:US
Mailing Address - Phone:415-398-4964
Mailing Address - Fax:415-398-0147
Practice Address - Street 1:490 POST STREET
Practice Address - Street 2:SUITE 1516
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-1302
Practice Address - Country:US
Practice Address - Phone:415-398-4964
Practice Address - Fax:415-398-0147
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA438131223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics