Provider Demographics
NPI:1336153899
Name:PARMAR, PRASHANT S
Entity Type:Individual
Prefix:
First Name:PRASHANT
Middle Name:S
Last Name:PARMAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 COFFEE ROAD #200
Mailing Address - Street 2:ACCESS DENTAL
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355
Mailing Address - Country:US
Mailing Address - Phone:209-521-0100
Mailing Address - Fax:209-521-0516
Practice Address - Street 1:2605 COFFEE ROAD #200
Practice Address - Street 2:ACCESS DENTAL
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355
Practice Address - Country:US
Practice Address - Phone:209-521-0100
Practice Address - Fax:209-521-0516
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA493861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice