Provider Demographics
NPI:1457484222
Name:MICHAEL K PARSONS DDS PC
Entity Type:Organization
Organization Name:MICHAEL K PARSONS DDS PC
Other - Org Name:MIDWEST ORAL AND MAXILLO FACIAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:636-536-5158
Mailing Address - Street 1:17300 OUTER FORTY ROAD NORTH
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005
Mailing Address - Country:US
Mailing Address - Phone:636-536-5158
Mailing Address - Fax:636-536-4544
Practice Address - Street 1:1630 MARKET CENTER BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368
Practice Address - Country:US
Practice Address - Phone:636-379-1333
Practice Address - Fax:636-379-1334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty