Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 10617 | MD |
NPI | 1316092992 |
---|---|
Provider Name | Dr. Kimberly Wycall Parker |
First Address | Salisbury, MD 21801-5300 |
Second Address | Salisbury, MD 21801-5300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 08/07/2007 |