Individual
DR. CLAYTON PARKS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.D., M.S
Contact information
Practice address
2727 1ST AVE SE, CEDAR RAPIDS, IA 52402-4844
(319) 363-3575
(319) 363-8886
Mailing address
2727 1ST AVE SE, CEDAR RAPIDS, IA 52402-4844
(319) 363-3575
(319) 363-8886
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
07934
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0210120
—
IA
01
—
08823
DELTA PROV #
IA
01
—
170453
UNITED CONCORDIA PROV#
IA
01
—
38293
BC/BS OF IA PROV#
IA
Enumeration date
02/17/2006
Last updated
07/09/2007
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