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General NPI Number Information
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NPI Number | 1831554526
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Entity Type | Organization
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Legal Business Name | J. WESLEY PARKER II, DDS, PLLC
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Dates
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Enumeration Date | 12/22/2015
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Last Update Date | 12/22/2015
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Provider Practice Location Address
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Address Line | 27 OFFICE PARK DR
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City | JACKSONVILLE
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State | NC
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Zip | 28546-3219
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Country | US
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Telephone | 910-577-7775
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Fax | 910-577-7199
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Provider Business Mailing Address
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Address Line | 27 OFFICE PARK DR
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City | JACKSONVILLE
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State | NC
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Zip | 28546-3219
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Country | US
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Telephone | 910-577-7775
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Fax | 910-577-7199
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN WESLEY PARKER II
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Credential | D.D.S.
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Telephone | 910-577-7775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 10219
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License Number State | NC
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