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General NPI Number Information
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NPI Number | 1326855123
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Entity Type | Individual
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Provider Name | PARKER LEWIS STANWAY DMD
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Gender | Male
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 78595 HIGHWAY 111 STE 300
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City | LA QUINTA
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State | CA
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Zip | 92253-2084
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Country | US
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Telephone | 760-771-0300
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Fax | 760-771-0420
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Provider Business Mailing Address
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Address Line | 35095 SERENADE
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City | THOUSAND PALMS
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State | CA
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Zip | 92276-4125
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Country | US
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Telephone | 760-799-7199
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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 | 111103
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License Number State | CA
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