Organization
WILL J PARKS DDS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILL PARKS JR. (OWNER)
(903) 526-7977
Entity
Organization
Contact information
Practice address
815 S FLEISHEL AVE, TYLER, TX 75701-2017
(903) 526-7977
(903) 526-7989
Mailing address
815 S FLEISHEL AVE, TYLER, TX 75701-2017
(903) 526-7977
(903) 526-7989
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
17107
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111311002
—
TX
Enumeration date
03/25/2011
Last updated
03/25/2011
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