Provider Demographics
NPI:1295260206
Name:PARR, ALLISON
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:PARR
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 1:2300 9TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-7112
Mailing Address - Country:US
Mailing Address - Phone:605-886-8394
Mailing Address - Fax:605-882-5209
Practice Address - Street 1:2300 9TH AVE SE
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-7112
Practice Address - Country:US
Practice Address - Phone:605-886-8394
Practice Address - Fax:605-882-5209
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-27
Last Update Date:2017-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD11671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice