Organization
RUSSELL C PARKER DMD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL PARKER DMD (OWNER)
(256) 350-5006
Entity
Organization
Contact information
Practice address
2012 DANVILLE PARK DR SW, DECATUR, AL 35603-1832
(256) 350-5006
Mailing address
2012 DANVILLE PARK DR SW, DECATUR, AL 35603-1832
(256) 350-5006
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D.007168-C
BOARD OF DENTAL EXAMINERS OF ALABAMA
AL
Enumeration date
10/27/2023
Last updated
10/27/2023
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