Individual
DR. JACOB PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1647 TAUSSIG BLVD, BLDG CD-3, NORFOLK, VA 23511
(253) 228-0689
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-7550
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60970005
WA
Other
Enumeration date
04/05/2019
Last updated
07/17/2019
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