Provider Demographics
NPI:1245728096
Name:PARKS, ALISON WHITE
Entity type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:WHITE
Last Name:PARKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HOLLY ST
Mailing Address - Street 2:
Mailing Address - City:ONANCOCK
Mailing Address - State:VA
Mailing Address - Zip Code:23417-1721
Mailing Address - Country:US
Mailing Address - Phone:757-709-4648
Mailing Address - Fax:
Practice Address - Street 1:5219 LANKFORD HWY
Practice Address - Street 2:
Practice Address - City:NEW CHURCH
Practice Address - State:VA
Practice Address - Zip Code:23415-3332
Practice Address - Country:US
Practice Address - Phone:757-824-5676
Practice Address - Fax:757-824-5872
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist