Provider Demographics
NPI:1003080714
Name:ROBERT H. PARISH, D.D.S., LTD.
Entity Type:Organization
Organization Name:ROBERT H. PARISH, D.D.S., LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:PARISH
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:618-576-2296
Mailing Address - Street 1:2 MYRTLE LANE
Mailing Address - Street 2:
Mailing Address - City:HARDIN
Mailing Address - State:IL
Mailing Address - Zip Code:62047
Mailing Address - Country:US
Mailing Address - Phone:618-576-2296
Mailing Address - Fax:618-576-9388
Practice Address - Street 1:2 MYRTLE LANE
Practice Address - Street 2:
Practice Address - City:HARDIN
Practice Address - State:IL
Practice Address - Zip Code:62047
Practice Address - Country:US
Practice Address - Phone:618-576-2296
Practice Address - Fax:618-576-9388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19A163651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty