Provider Demographics
NPI:1194856732
Name:PARSONS, GREGORY J (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:J
Last Name:PARSONS
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 1:5027 REGENTS PARK RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-5025
Mailing Address - Country:US
Mailing Address - Phone:815-398-3475
Mailing Address - Fax:
Practice Address - Street 1:2835 MCFARLAND RD
Practice Address - Street 2:SUITE B
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-6819
Practice Address - Country:US
Practice Address - Phone:815-636-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics