Healthcare Provider Details

I. General information

NPI: 1669718516
Provider Name (Legal Business Name): PARKINSON - BUTLER ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2012
Last Update Date: 12/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 COLUMBIA POINT DR STE 105
RICHLAND WA
99352-4390
US

IV. Provider business mailing address

112 COLUMBIA POINT DR STE 105
RICHLAND WA
99352-4390
US

V. Phone/Fax

Practice location:
  • Phone: 509-946-7689
  • Fax: 509-946-8312
Mailing address:
  • Phone: 509-946-7689
  • Fax: 509-946-8312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number25103DE00009
License Number StateWA

VIII. Authorized Official

Name: DR. CHRISTOPHER E PARKINSON
Title or Position: OWNER
Credential: DDS
Phone: 509-946-7689