Provider Demographics
NPI:1982133955
Name:DUKE, PARKER L (DMD)
Entity Type:Individual
Prefix:DR
First Name:PARKER
Middle Name:L
Last Name:DUKE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 E PARK ST
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33823-3411
Mailing Address - Country:US
Mailing Address - Phone:863-967-7548
Mailing Address - Fax:
Practice Address - Street 1:308 E PARK ST
Practice Address - Street 2:
Practice Address - City:AUBURNDALE
Practice Address - State:FL
Practice Address - Zip Code:33823-3411
Practice Address - Country:US
Practice Address - Phone:863-967-7548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2017-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN226291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice