Provider Demographics
NPI:1518215748
Name:PARRY, TRISTAN JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:TRISTAN
Middle Name:JAMES
Last Name:PARRY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 PARK ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-4225
Mailing Address - Country:US
Mailing Address - Phone:541-258-4746
Mailing Address - Fax:541-258-4745
Practice Address - Street 1:1009 NC HIGHWAY 150 W
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:NC
Practice Address - Zip Code:27358-9074
Practice Address - Country:US
Practice Address - Phone:366-644-2770
Practice Address - Fax:366-644-2778
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC117321223G0001X
SC80901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice