Healthcare Provider Details

I. General information

NPI: 1336199488
Provider Name (Legal Business Name): TONY PARSLEY D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1765 SW PARKWAY DR
REDMOND OR
97756-2550
US

IV. Provider business mailing address

1765 SW PARKWAY DR
REDMOND OR
97756-2550
US

V. Phone/Fax

Practice location:
  • Phone: 541-548-8175
  • Fax:
Mailing address:
  • Phone: 541-548-8175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD7782
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: