Provider Demographics
NPI:1720242563
Name:BAIG, PARVEZ (DMD, MPH)
Entity Type:Individual
Prefix:
First Name:PARVEZ
Middle Name:
Last Name:BAIG
Suffix:
Gender:M
Credentials:DMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 S HWY 17 92 STE 100
Mailing Address - Street 2:
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713-1832
Mailing Address - Country:US
Mailing Address - Phone:386-668-2181
Mailing Address - Fax:386-668-8910
Practice Address - Street 1:189 S HWY 17 92 STE 100
Practice Address - Street 2:
Practice Address - City:DEBARY
Practice Address - State:FL
Practice Address - Zip Code:32713-1832
Practice Address - Country:US
Practice Address - Phone:386-668-2181
Practice Address - Fax:386-668-8910
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22183122300000X
CT0103891223G0001X
FLDN237541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist