Provider Demographics
NPI:1275673410
Name:DALE R. PARRY, D.D.S., INC
Entity Type:Organization
Organization Name:DALE R. PARRY, D.D.S., INC
Other - Org Name:PLAZA DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:PARRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-653-0620
Mailing Address - Street 1:4744 TELEPHONE RD STE 4
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-5258
Mailing Address - Country:US
Mailing Address - Phone:805-653-0620
Mailing Address - Fax:805-658-6459
Practice Address - Street 1:4744 TELEPHONE RD STE 4
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-5258
Practice Address - Country:US
Practice Address - Phone:805-653-0620
Practice Address - Fax:805-658-6459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty