Provider Demographics
NPI:1881872299
Name:DR. DAVID PARSONS D.D.S PA
Entity type:Organization
Organization Name:DR. DAVID PARSONS D.D.S PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BYERLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-498-2404
Mailing Address - Street 1:215 W NAOMI ST
Mailing Address - Street 2:
Mailing Address - City:RANDLEMAN
Mailing Address - State:NC
Mailing Address - Zip Code:27317-1733
Mailing Address - Country:US
Mailing Address - Phone:336-498-2404
Mailing Address - Fax:336-495-6544
Practice Address - Street 1:215 W NAOMI ST
Practice Address - Street 2:
Practice Address - City:RANDLEMAN
Practice Address - State:NC
Practice Address - Zip Code:27317-1733
Practice Address - Country:US
Practice Address - Phone:336-498-2404
Practice Address - Fax:336-495-6544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8996641Medicaid