Organization
PARKS FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN RAY PARKS D.D.S. (DENTIST)
(580) 371-3900
Entity
Organization
Contact information
Practice address
1520 EAST MAIN STREET, TISHOMINGO, OK 73460
(580) 371-3900
(580) 371-3903
Mailing address
1520 EAST MAIN STREET, TISHOMINGO, OK 73460
(580) 371-3900
(580) 371-3903
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
1124
OK
Other
Enumeration date
02/15/2012
Last updated
02/15/2012
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