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NPI Code Detail

MEDICARE: MR. RALPH FRIDOLIN PARKIN DMD

MEDICARE:  MR. RALPH FRIDOLIN PARKIN  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist104559CO

General Provider Information

NPI Number : 1205943172
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RALPH FRIDOLIN PARKIN DMD
Provider Business Mailing Address
First Line : 1803 B STREET
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80906
Country : US
Telephone Number : 719-576-1730
Fax Number : 719-576-3456
Provider Business Practice Location Address
First Line : 1803 B STREET
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80906
Country : US
Telephone Number : 719-576-1730
Fax Number : 719-576-3456
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2006
Last Update Date : 07/08/2007

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