Provider Demographics
NPI:1750506622
Name:PARRINO, PATRICK A (DDS)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:A
Last Name:PARRINO
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 1:19 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30747
Mailing Address - Country:US
Mailing Address - Phone:706-857-4741
Mailing Address - Fax:706-857-2713
Practice Address - Street 1:19 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:GA
Practice Address - Zip Code:30747
Practice Address - Country:US
Practice Address - Phone:706-857-4741
Practice Address - Fax:706-857-2713
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0066691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice