Basic Information
| Provider Information | |||||||||
| NPI: | 1174506745 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARKER | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3200 SOUTH UNIVERSITY DRIVE | ||||||||
| Address2: | NSU COLLEGE OF DENTAL MEDICINE DEPT OF PERIODONTOLOGY | ||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9542627330 | ||||||||
| FaxNumber: | 9542621782 | ||||||||
| Practice Location | |||||||||
| Address1: | 3200 SOUTH UNIVERSITY DRIVE | ||||||||
| Address2: | NSU COLLEGE OF DENTAL MEDICINE DEPT OF PERIODONTOLOGY | ||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9542627330 | ||||||||
| FaxNumber: | 9542621782 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2005 | ||||||||
| LastUpdateDate: | 12/12/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223P0300X | 0401008175 | VA | N | Dental Providers | Dentist | Periodontics | 1223P0300X | 480 | FL | Y | Dental Providers | Dentist | Periodontics |
No ID Information.