Provider Demographics
NPI:1508807124
Name:PARKMAN, TERRY E (DMD,PC)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:E
Last Name:PARKMAN
Suffix:
Gender:M
Credentials:DMD,PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 SUNSET DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2293
Mailing Address - Country:US
Mailing Address - Phone:706-546-7149
Mailing Address - Fax:706-546-6468
Practice Address - Street 1:700 SUNSET DR
Practice Address - Street 2:SUITE 401
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2293
Practice Address - Country:US
Practice Address - Phone:706-546-7149
Practice Address - Fax:706-546-6468
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA85331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice