Provider Demographics
NPI:1992045678
Name:ANTHONY PARISEK, DDS, PLLC
Entity Type:Organization
Organization Name:ANTHONY PARISEK, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARISEK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:507-587-8136
Mailing Address - Street 1:301 JEWETT ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-2624
Mailing Address - Country:US
Mailing Address - Phone:507-537-9667
Mailing Address - Fax:
Practice Address - Street 1:301 JEWETT ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-2624
Practice Address - Country:US
Practice Address - Phone:507-537-9667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-18
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNC1470122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty