Provider Demographics
NPI:1013651546
Name:EASTERN SHORE DENTAL, P.C.
Entity type:Organization
Organization Name:EASTERN SHORE DENTAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-626-0640
Mailing Address - Street 1:2213 US HIGHWAY 98
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-4365
Mailing Address - Country:US
Mailing Address - Phone:251-626-0640
Mailing Address - Fax:
Practice Address - Street 1:2213 US HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-4365
Practice Address - Country:US
Practice Address - Phone:251-626-0640
Practice Address - Fax:251-626-1922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental