Provider Demographics
NPI:1700206315
Name:PARKER ORTHODONTICS, LLC
Entity Type:Organization
Organization Name:PARKER ORTHODONTICS, LLC
Other - Org Name:PARKER ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORTHODONTIST/OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:225-923-2060
Mailing Address - Street 1:622 SHADOWS LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-6500
Mailing Address - Country:US
Mailing Address - Phone:225-923-2060
Mailing Address - Fax:225-927-1817
Practice Address - Street 1:622 SHADOWS LN
Practice Address - Street 2:SUITE B
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-6500
Practice Address - Country:US
Practice Address - Phone:225-923-2060
Practice Address - Fax:225-927-1817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty