Provider Demographics
NPI:1912339706
Name:PARKS, BRITTANY PAUGH (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:PAUGH
Last Name:PARKS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 E 10TH ST STE 106
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5771
Mailing Address - Country:US
Mailing Address - Phone:256-741-7310
Mailing Address - Fax:256-741-7373
Practice Address - Street 1:310 W ELM ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-4802
Practice Address - Country:US
Practice Address - Phone:256-262-0200
Practice Address - Fax:256-262-0201
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6042122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist