Healthcare Provider Details

I. General information

NPI: 1457484222
Provider Name (Legal Business Name): MICHAEL K PARSONS DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 MARKET CENTER BLVD SUITE 102
O FALLON MO
63368
US

IV. Provider business mailing address

17300 OUTER FORTY ROAD NORTH SUITE 103
CHESTERFIELD MO
63005
US

V. Phone/Fax

Practice location:
  • Phone: 636-379-1333
  • Fax: 636-379-1334
Mailing address:
  • Phone: 636-536-5158
  • Fax: 636-536-4544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL KEITH PARSONS
Title or Position: OWNER PRESIDENT
Credential: DDS
Phone: 636-536-5158