Individual
DR. CHARLES ORVILLE PARKER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
219 PRINCETON RD, JOHNSON CITY, TN 37601-2062
(423) 975-2200
Mailing address
130 TUCKER LN, JOHNSON CITY, TN 37601-2947
(423) 282-6564
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
DS0000003337
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1532259
—
TN
Enumeration date
11/30/2006
Last updated
09/16/2013
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