Provider Demographics
NPI:1528056835
Name:KING, DARRIN LEE (DDS)
Entity type:Individual
Prefix:DR
First Name:DARRIN
Middle Name:LEE
Last Name:KING
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Gender:M
Credentials:DDS
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Mailing Address - Street 1:1575 20TH STREET NW
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FARIBAULT
Mailing Address - State:MN
Mailing Address - Zip Code:55021-5780
Mailing Address - Country:US
Mailing Address - Phone:507-332-0022
Mailing Address - Fax:507-333-9553
Practice Address - Street 1:1575 20TH STREET NW
Practice Address - Street 2:SUITE 202
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-5780
Practice Address - Country:US
Practice Address - Phone:507-332-0022
Practice Address - Fax:507-333-9553
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2008-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MND111711223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics