Individual
DR. JEREMIAH J PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
10TH MEDICAL GROUP, 4102 PINION DRIVE, USAF ACADEMY, CO 80132
(571) 275-8412
Mailing address
18620 KNOLLWOOD BLVD, MONUMENT, CO 80132-8970
(571) 275-8412
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
7025150-9921
UT
1223E0200X
Endodontics
Primary
7025150-9921
UT
Other
Enumeration date
05/28/2008
Last updated
11/01/2023
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