Provider Demographics
NPI:1033260765
Name:DR. KIMBERLY WAGLER PARSONS, P.C.
Entity Type:Organization
Organization Name:DR. KIMBERLY WAGLER PARSONS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:WAGLER
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:812-254-4684
Mailing Address - Street 1:2 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47501-2753
Mailing Address - Country:US
Mailing Address - Phone:812-254-4684
Mailing Address - Fax:812-254-3008
Practice Address - Street 1:2 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47501-2753
Practice Address - Country:US
Practice Address - Phone:812-254-4684
Practice Address - Fax:812-254-3008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010457A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty