Healthcare Provider Details

I. General information

NPI: 1548335607
Provider Name (Legal Business Name): ANTHONY VINCENT PARLATO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

663 MAIN STREET
LAUREL MD
20707-4067
US

IV. Provider business mailing address

663 MAIN STREET
LAUREL MD
20707-4067
US

V. Phone/Fax

Practice location:
  • Phone: 301-953-1981
  • Fax: 301-953-1983
Mailing address:
  • Phone: 301-953-1981
  • Fax: 301-953-1983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number5125
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: