Individual
ANNA PARKHOMENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1585 MALLORY LN STE 101, BRENTWOOD, TN 37027-3036
(615) 377-6306
Mailing address
530 S WAKARA WAY, SALT LAKE CITY, UT 84108-1213
(801) 587-2162
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12161
TN
Other
Enumeration date
04/19/2022
Last updated
10/11/2023
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