Doctor Name: | DR. ALLEN PARKS |
NPI Number: | 1538266135 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DDS |
License Number: | 23320 |
Business Practice Address: | 431 Broadway Lawrence, NY - 11559 |
Business Phone Number: | 5163742566 |
Business Fax Number: | 5163742566 |
Mailing Address: | 431 Broadway, LAWRENCE |
State: | NY |
Postal Code: | 11559 |
Phone Number: | 5163742566 |
Fax Number: | 5163742566 |
NPI Enumeration Date: | 09/19/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 23320 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |