Provider Demographics
NPI:1548378896
Name:PARHAM, MONICA PAIGE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:PAIGE
Last Name:PARHAM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 CLAIRMONT RD
Mailing Address - Street 2:
Mailing Address - City:STERRETT
Mailing Address - State:AL
Mailing Address - Zip Code:35147-7013
Mailing Address - Country:US
Mailing Address - Phone:301-974-7769
Mailing Address - Fax:
Practice Address - Street 1:4701 MISTY RIDGE CIR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-8688
Practice Address - Country:US
Practice Address - Phone:205-508-3403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC6361122300000X
MD118741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice