Provider Demographics
NPI:1467040881
Name:PARK DENTISTRY FOR KIDS, PLLC
Entity Type:Organization
Organization Name:PARK DENTISTRY FOR KIDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-993-7332
Mailing Address - Street 1:102 HEIGHTS BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-3729
Mailing Address - Country:US
Mailing Address - Phone:713-993-7332
Mailing Address - Fax:
Practice Address - Street 1:102 HEIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-3729
Practice Address - Country:US
Practice Address - Phone:713-993-7332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-03
Last Update Date:2021-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental