Provider Demographics
NPI:1043898133
Name:WESPARK FAMILY DENTISTRY, PC
Entity Type:Organization
Organization Name:WESPARK FAMILY DENTISTRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:478-987-7863
Mailing Address - Street 1:233 WES PARK DR
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:GA
Mailing Address - Zip Code:31069-4829
Mailing Address - Country:US
Mailing Address - Phone:478-987-7863
Mailing Address - Fax:478-987-7756
Practice Address - Street 1:233 WES PARK DR
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:GA
Practice Address - Zip Code:31069-4829
Practice Address - Country:US
Practice Address - Phone:478-987-7863
Practice Address - Fax:478-987-7756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental