Healthcare Provider Details

I. General information

NPI: 1720130396
Provider Name (Legal Business Name): ANTHONY V PARLATO DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 08/22/2020
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: DR. ANTHONY VINCENT PARLATO
Title or Position: PRES OWNER
Credential: DDS
Phone: 301-953-1981