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General NPI Number Information
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NPI Number | 1083908875
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Entity Type | Individual
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Provider Name | RICHARD ANTHONY PARKER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/09/2011
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Last Update Date | 01/05/2013
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Provider Practice Location Address
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Address Line | 300 HICKMAN RD STE 101
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-3554
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Country | US
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Telephone | 434-973-2520
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Fax |
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Provider Business Mailing Address
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Address Line | 2293 WHITTINGTON DR
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-3577
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Country | US
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Telephone | 315-790-2650
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401413214
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License Number State | VA
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