Provider Demographics
NPI:1205909033
Name:PARKER, DONALD G (DDS)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:G
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 1:5443 PARK HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-4615
Mailing Address - Country:US
Mailing Address - Phone:410-542-1600
Mailing Address - Fax:410-542-2938
Practice Address - Street 1:5443 PARK HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-4615
Practice Address - Country:US
Practice Address - Phone:410-542-1600
Practice Address - Fax:410-542-2938
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD48711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice