Provider Demographics
NPI:1932254174
Name:GATES W. PARKER, DMD
Entity Type:Organization
Organization Name:GATES W. PARKER, DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GATES
Authorized Official - Middle Name:WASHBURN
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:570-828-2351
Mailing Address - Street 1:RR 2 BOX 225
Mailing Address - Street 2:
Mailing Address - City:DINGMANS FERRY
Mailing Address - State:PA
Mailing Address - Zip Code:18328-9629
Mailing Address - Country:US
Mailing Address - Phone:570-828-2351
Mailing Address - Fax:570-828-6319
Practice Address - Street 1:934 MILFORD RD
Practice Address - Street 2:
Practice Address - City:DINGMANS FERRY
Practice Address - State:PA
Practice Address - Zip Code:18328-9629
Practice Address - Country:US
Practice Address - Phone:570-828-2351
Practice Address - Fax:570-828-6319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-024516-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1326057530OtherINDIVIDUAL NPI