Provider Demographics
NPI:1578850442
Name:PARKHURST, DELINA M (DMD)
Entity Type:Individual
Prefix:DR
First Name:DELINA
Middle Name:M
Last Name:PARKHURST
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 BARCLAY SHOPPING CTR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2130
Mailing Address - Country:US
Mailing Address - Phone:856-288-3708
Mailing Address - Fax:856-288-7845
Practice Address - Street 1:75 BARCLAY SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2130
Practice Address - Country:US
Practice Address - Phone:610-570-1255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ248321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program