Provider Demographics
NPI:1073627238
Name:PARISH, PATRICK BYRON (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:BYRON
Last Name:PARISH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28001 STATE HIGHWAY 115
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73507-8589
Mailing Address - Country:US
Mailing Address - Phone:817-683-2178
Mailing Address - Fax:
Practice Address - Street 1:6037 BESSINGER RD
Practice Address - Street 2:
Practice Address - City:FT. SILL
Practice Address - State:OK
Practice Address - Zip Code:73503
Practice Address - Country:US
Practice Address - Phone:580-442-5544
Practice Address - Fax:580-442-7150
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8902122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist