Provider Demographics
NPI:1740423920
Name:PARKER, WILLIAM CALVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CALVIN
Last Name:PARKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12682 OLD WICK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-1936
Mailing Address - Country:US
Mailing Address - Phone:210-492-9108
Mailing Address - Fax:
Practice Address - Street 1:12682 OLD WICK CIRCLE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-1936
Practice Address - Country:US
Practice Address - Phone:210-492-9108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX8319122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist