# ESI AND TRAVIS PARKER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Goris Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801482534
- **Authorized official:** DR. ESO PARKER DMD (GENERAL DENTIST)
- **Authorized official phone:** (574) 753-4542

## Contact information

- **Practice address:** 1821 CHASE RD, LOGANSPORT, IN 46947-1200
- **Practice address phone:** (574) 753-4542
- **Mailing address:** 1821 CHASE RD, LOGANSPORT, IN 46947-1200
- **Mailing address phone:** (574) 753-4542

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 12/16/2020
- **Last updated:** 12/16/2020