Provider Demographics
NPI:1497848253
Name:PARSONS, STEVEN GALE
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:GALE
Last Name:PARSONS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 E MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:WATSEKA
Mailing Address - State:IL
Mailing Address - Zip Code:60970-1653
Mailing Address - Country:US
Mailing Address - Phone:815-432-4882
Mailing Address - Fax:815-432-5141
Practice Address - Street 1:223 E MULBERRY ST
Practice Address - Street 2:
Practice Address - City:WATSEKA
Practice Address - State:IL
Practice Address - Zip Code:60970-1653
Practice Address - Country:US
Practice Address - Phone:815-432-4882
Practice Address - Fax:815-432-5141
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist