Healthcare Provider Details

I. General information

NPI: 1245935360
Provider Name (Legal Business Name): PARROTT ORTHODONTICS DRE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2023
Last Update Date: 03/31/2023
Certification Date: 03/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 GOSNELL XING
STAUNTON VA
24401-6297
US

IV. Provider business mailing address

105 SPRUCE ST
LEXINGTON KY
40507-2109
US

V. Phone/Fax

Practice location:
  • Phone: 859-785-8312
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: GREGORY WHITE
Title or Position: CEO
Credential: DDS
Phone: 859-785-8312