Healthcare Provider Details

I. General information

NPI: 1295822476
Provider Name (Legal Business Name): NOEL FRANCIS PARRIS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 11/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 BAKER RD SUITE 6
NEWNAN GA
30265-2134
US

IV. Provider business mailing address

20 BAKER RD SUITE 6
NEWNAN GA
30265-2134
US

V. Phone/Fax

Practice location:
  • Phone: 678-854-0169
  • Fax: 678-854-0174
Mailing address:
  • Phone: 678-854-0169
  • Fax: 678-854-0174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN012880
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number31682
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: