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NPI Code Detail

MEDICARE: DR. SANDY L. PARROTT D.D.S.

MEDICARE:  DR. SANDY L. PARROTT  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry9261MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1382011210OTHERMITAX ID #

General Provider Information

NPI Number : 1619064599
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SANDY L. PARROTT D.D.S.
Provider Business Mailing Address
First Line : 1017 HURON AVE
Second Line :
City : PORT HURON
State : MI
Zip : 48060-3770
Country : US
Telephone Number : 810-984-3700
Fax Number : 810-984-4313
Provider Business Practice Location Address
First Line : 1017 HURON AVE
Second Line :
City : PORT HURON
State : MI
Zip : 48060-3770
Country : US
Telephone Number : 810-984-3700
Fax Number : 810-984-4313
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 07/08/2007

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Directions to “ DR. SANDY L. PARROTT D.D.S.” Practice Location

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