Provider Demographics
NPI:1497996821
Name:PARKER, DANA RAFFERTY (DMD, MED)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:RAFFERTY
Last Name:PARKER
Suffix:
Gender:F
Credentials:DMD, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SAINT FRANCIS DR
Mailing Address - Street 2:PMC BUILDING SUITE 250
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-3955
Mailing Address - Country:US
Mailing Address - Phone:864-255-1800
Mailing Address - Fax:864-255-1349
Practice Address - Street 1:1 SAINT FRANCIS DR
Practice Address - Street 2:PMC BUILDING SUITE 250
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3955
Practice Address - Country:US
Practice Address - Phone:864-255-1800
Practice Address - Fax:864-255-1349
Is Sole Proprietor?:No
Enumeration Date:2009-03-15
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4452122300000X
KY6377122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist