Provider Demographics
NPI:1487045811
Name:DAVID L PARKER DDS PC
Entity Type:Organization
Organization Name:DAVID L PARKER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:865-805-7775
Mailing Address - Street 1:7541 CROSSWOOD BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37924-3935
Mailing Address - Country:US
Mailing Address - Phone:865-524-7775
Mailing Address - Fax:865-525-7740
Practice Address - Street 1:7541 CROSSWOOD BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37924-3935
Practice Address - Country:US
Practice Address - Phone:865-524-7775
Practice Address - Fax:865-525-7740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN73171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty