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General NPI Number Information
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NPI Number | 1346622818
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Entity Type | Individual
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Provider Name | MEAGAN MAIDA PARKER D.M.D
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Gender | Female
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Dates
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Enumeration Date | 06/22/2015
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Last Update Date | 02/15/2017
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Provider Practice Location Address
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Address Line | 12330 HIGHWAY 210, SUITE #115
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City | BENSON
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State | NC
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Zip | 27504
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Country | US
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Telephone | 919-207-2077
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Fax |
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Provider Business Mailing Address
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Address Line | 324 WICKERLEAF WAY
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City | GARNER
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State | NC
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Zip | 27529-8382
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Country | US
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Telephone | 910-890-6793
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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 | 10149
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License Number State | NC
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