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NPI Code Detail

MEDICARE: DR. STEPHEN THOMAS PARKER DMD

MEDICARE: DR. STEPHEN THOMAS PARKER 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
11223G0001XGeneral Practice Dentistry9692FL

General Provider Information

NPI Number : 1760533798
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN THOMAS PARKER DMD
Provider Business Mailing Address
First Line : 1003 N 35TH AVE
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-5402
Country : US
Telephone Number : 954-983-5450
Fax Number : 954-983-3846
Provider Business Practice Location Address
First Line : 1003 N 35TH AVE
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-5402
Country : US
Telephone Number : 954-983-5450
Fax Number : 954-983-3846
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2007
Last Update Date : 07/08/2007

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