Provider Demographics
NPI:1710172846
Name:PARKER, RAYMOND BLISS JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:BLISS
Last Name:PARKER
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7509 SIX FORKS RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5020
Mailing Address - Country:US
Mailing Address - Phone:919-847-5959
Mailing Address - Fax:919-844-9341
Practice Address - Street 1:7509 SIX FORKS RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5020
Practice Address - Country:US
Practice Address - Phone:919-847-5959
Practice Address - Fax:919-844-9341
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC59751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice