MEDICARE: DR. MILTON ANDREW PARKER 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
1	122300000X	Dentist	0401006692	VA

General Provider Information

NPI Number	:	1639240716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MILTON ANDREW PARKER D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 6416
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-0416
Country	:	US
Telephone Number	:	703-799-0655
Fax Number	:

Provider Business Practice Location Address
First Line	:	7700D RICHMOND HWY
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-2803
Country	:	US
Telephone Number	:	703-799-0655
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2006
Last Update Date	:	07/08/2007

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