Provider Demographics
NPI:1508865577
Name:PARKWAY DENTAL HEALTH PROFESSIONALS
Entity Type:Organization
Organization Name:PARKWAY DENTAL HEALTH PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:H
Authorized Official - Last Name:ZIPF
Authorized Official - Suffix:
Authorized Official - Credentials:D D S
Authorized Official - Phone:937-435-9110
Mailing Address - Street 1:6450 CENTERVILLE BUSINESS PKWY
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-2633
Mailing Address - Country:US
Mailing Address - Phone:937-435-9110
Mailing Address - Fax:937-435-0918
Practice Address - Street 1:6450 CENTERVILLE BUSINESS PKWY
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-2633
Practice Address - Country:US
Practice Address - Phone:937-435-9110
Practice Address - Fax:937-435-0918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30015235122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty