Individual
DR. JOHNATHAN CARL PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
9430 BUFFALO RD, PALMETTO, FL 34221-8687
(866) 929-0040
Mailing address
8501 CACHE DR, SARASOTA, FL 34240-2710
(561) 459-0947
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
25093
FL
Other
Enumeration date
06/17/2020
Last updated
08/08/2021
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