Provider Demographics
NPI:1275669061
Name:PARKER, CHRISTOPHER D (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:D
Last Name:PARKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3427 DEER PARK DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-2355
Mailing Address - Country:US
Mailing Address - Phone:209-476-8858
Mailing Address - Fax:209-476-1736
Practice Address - Street 1:3427 DEER PARK DR
Practice Address - Street 2:SUITE D
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95219-2355
Practice Address - Country:US
Practice Address - Phone:209-476-8858
Practice Address - Fax:209-476-1736
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA375901223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA514066OtherDENTI-CAL