Provider Demographics
NPI:1346622818
Name:PARKER, MEAGAN MAIDA (DMD)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:MAIDA
Last Name:PARKER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 WICKERLEAF WAY
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-8382
Mailing Address - Country:US
Mailing Address - Phone:910-890-6793
Mailing Address - Fax:
Practice Address - Street 1:12330 HIGHWAY 210, SUITE #115
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:NC
Practice Address - Zip Code:27504
Practice Address - Country:US
Practice Address - Phone:919-207-2077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10149122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist