Basic Information
Provider Information
NPI: 1346202546
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARRISH
FirstName: NATHAN
MiddleName: CHRISTIAN
NamePrefix: DR.
NameSuffix:  
Credential: DDS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2776 RINGGOLD RD
Address2: HQS, USA DENTAC
City: FT SILL
State: OK
PostalCode: 735036300
CountryCode: US
TelephoneNumber: 5804423905
FaxNumber: 5804424002
Practice Location
Address1: 2776 RINGGOLD RD
Address2: HQ, USA DENTAC
City: FT SILL
State: OK
PostalCode: 735036300
CountryCode: US
TelephoneNumber: 5804423905
FaxNumber: 5804424002
Other Information
ProviderEnumerationDate: 04/04/2006
LastUpdateDate: 08/30/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1223G0001X5722OKY Dental ProvidersDentistGeneral Practice

No ID Information.


Home