Individual
MR. PARKS BURTON ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
114 LAURENS RD STE A, GREENVILLE, SC 29607-1826
(864) 336-8478
(864) 509-1514
Mailing address
PO BOX 799, SIMPSONVILLE, SC 29681-0799
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4025
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1783199
UNITED CONCORDIA INSUR
SC
Enumeration date
11/21/2005
Last updated
06/04/2021
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