# DARRELL DEEM DDS, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669866992
- **Authorized official:** L. RENE BEAN (OFFICE ADMINISTRATION)
- **Authorized official phone:** (812) 254-5011

## Contact information

- **Practice address:** 100 W VAN TREES ST, WASHINGTON, IN 47501-1564
- **Practice address phone:** (812) 254-7550
- **Practice address fax:** (812) 254-5750
- **Mailing address:** 100 W VAN TREES ST, WASHINGTON, IN 47501-1564
- **Mailing address phone:** (812) 254-7550
- **Mailing address fax:** (812) 254-5750

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12008380 | IN | Yes |

## Other

- **Enumeration date:** 03/25/2015
- **Last updated:** 03/25/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100089370A | — | IN |