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General NPI Number Information
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NPI Number | 1407142698
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER A. PARKS, DDS, P.C.
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Dates
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Enumeration Date | 06/25/2011
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Last Update Date | 06/25/2011
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Provider Practice Location Address
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Address Line | 400 CUMBERLAND WAY SUITE A
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City | SULLIVAN
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State | MO
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Zip | 63080-3321
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Country | US
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Telephone | 573-468-7556
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Fax |
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Provider Business Mailing Address
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Address Line | 400 CUMBERLAND WAY SUITE A
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City | SULLIVAN
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State | MO
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Zip | 63080-3321
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Country | US
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Telephone | 573-468-7556
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER PARKS
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Credential | DDS
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Telephone | 573-468-7556
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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 |
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License Number State |
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