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Organization
TY PARKER DMD PC
Active
Organization
TY PARKER DMD PC
Active
Other names
Fountains Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE MCCANN (OFFICE MANAGER)
(618) 622-1800
Entity
Organization
Contact information
Practice address
314 FOUNTAINS PKWY STE C, FAIRVIEW HEIGHTS, IL 62208-2165
(618) 622-1800
(618) 622-0007
Mailing address
314 FOUNTAINS PKWY STE C, FAIRVIEW HEIGHTS, IL 62208-2165
(618) 622-1800
(618) 622-0007
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/12/2019
Last updated
06/12/2019
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