Provider Demographics
NPI:1639340318
Name:PARKHURST AND BELISLE, DDS, PLLC
Entity Type:Organization
Organization Name:PARKHURST AND BELISLE, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOREY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:PARKHURST
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-392-1905
Mailing Address - Street 1:5503 OLEANDER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-5813
Mailing Address - Country:US
Mailing Address - Phone:910-392-1905
Mailing Address - Fax:910-392-0462
Practice Address - Street 1:5503 OLEANDER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5813
Practice Address - Country:US
Practice Address - Phone:910-392-1905
Practice Address - Fax:910-392-0462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6167122300000X
NC7586122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty