MEDICARE: DR. COLEMAN HARDING PARKER D.M.D.

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	6657	NV
2	1223G0001X	General Practice Dentistry	6657	NV

General Provider Information

NPI Number	:	1730560475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COLEMAN HARDING PARKER D.M.D.

Provider Business Mailing Address
First Line	:	3057 E WARM SPRINGS RD STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3763
Country	:	US
Telephone Number	:	702-757-1573
Fax Number	:

Provider Business Practice Location Address
First Line	:	3057 E WARM SPRINGS RD STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3763
Country	:	US
Telephone Number	:	702-757-1573
Fax Number	:

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

Provider Enumeration Date	:	06/17/2015
Last Update Date	:	06/17/2015

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Directions to “ DR. COLEMAN HARDING PARKER D.M.D.” Practice Location

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