Organization
SANDRA PARKER DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA PARKER DDS (SHARE HOLDER)
(714) 289-0421
Entity
Organization
Contact information
Practice address
807 E KATELLA AVE, ORANGE, CA 92867-4920
(714) 289-0421
(714) 289-0408
Mailing address
807 E KATELLA AVE, ORANGE, CA 92867-4920
(714) 289-0421
(714) 289-0408
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
50505
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G93900-01
MEDICAL
CA
Enumeration date
05/19/2010
Last updated
05/19/2010
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