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General NPI Number Information
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NPI Number | 1184784290
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Entity Type | Organization
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Legal Business Name | DR. JERRY L. PARKER D.M.D.
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1263 CENTER POINT PKWY SUITE A
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City | BIRMINGHAM
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State | AL
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Zip | 35215-6347
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Country | US
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Telephone | 205-856-0148
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Fax | 205-856-3018
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Provider Business Mailing Address
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Address Line | 1263 CENTER POINT PKWY SUITE A
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City | BIRMINGHAM
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State | AL
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Zip | 35215-6347
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Country | US
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Telephone | 205-856-0148
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Fax | 205-856-3018
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Authorized Official
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Title or Position | DENTIST
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Name | JERRY LEE PARKER
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Credential |
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Telephone | 205-856-0148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 2781
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License Number State | AL
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