Provider Demographics
NPI:1366534430
Name:DARDEN, JAMES MADISON JR (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MADISON
Last Name:DARDEN
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2400 WISTERIA DR
Mailing Address - Street 2:STE D
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078
Mailing Address - Country:US
Mailing Address - Phone:770-979-7794
Mailing Address - Fax:770-978-4975
Practice Address - Street 1:2400 WISTERIA DR
Practice Address - Street 2:STE D
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078
Practice Address - Country:US
Practice Address - Phone:770-979-7794
Practice Address - Fax:770-978-4975
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GADN0103101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice