Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 28217 | CA |
NPI | 1033394127 |
---|---|
Provider Name | Dr. Richard K Parris |
First Address | Orange, CA 92865-1909 |
Second Address | Orange, CA 92865-1909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2008 |
Last Update Date | 08/01/2008 |