Individual
DARREN LINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
5045 W BASELINE RD STE 135, LAVEEN, AZ 85339-7394
(602) 237-0613
(602) 237-0365
Mailing address
5045 W BASELINE RD STE 135, LAVEEN, AZ 85339-7394
(602) 237-0613
(602) 237-0365
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D009283
AZ
1223G0001X
General Practice Dentistry
019024363
IL
Other
Enumeration date
05/22/2007
Last updated
01/17/2019
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