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General NPI Number Information
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NPI Number | 1871972687
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Entity Type | Organization
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Legal Business Name | RICHARD A. PARKIN, DDS, PC
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Dates
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Enumeration Date | 05/26/2015
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Last Update Date | 05/26/2015
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Provider Practice Location Address
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Address Line | 4046 S HIGHLAND DR STE 113
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City | SALT LAKE CITY
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State | UT
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Zip | 84124-1689
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Country | US
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Telephone | 801-272-9003
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Fax |
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Provider Business Mailing Address
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Address Line | 4046 S HIGHLAND DR STE 113
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City | SALT LAKE CITY
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State | UT
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Zip | 84124-1689
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Country | US
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Telephone | 801-272-9003
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD PARKIN
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Credential | DDS
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Telephone | 801-272-9003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 1444149922
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License Number State | UT
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