Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Dental |
261QD0000X |
| NPI Number | 1548652225 |
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| LBN Legal business name | DARRELL W HEDRICK DDS LLC | ||||
| Authorized official | DARRELL HEDRICK - (OWNER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 03/04/2015 | ||||
| Last updated | 03/04/2015 - About 11 years ago | ||||
| Identifiers |
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