Provider Demographics
NPI:1124109384
Name:PARNES, GARY WAYNE (BSA, DDS)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:WAYNE
Last Name:PARNES
Suffix:
Gender:M
Credentials:BSA, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2280 HOPEWELL PLANTATION DRIVE
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004
Mailing Address - Country:US
Mailing Address - Phone:678-566-3094
Mailing Address - Fax:678-990-4072
Practice Address - Street 1:875 N MAIN ST
Practice Address - Street 2:SUITE 359
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-8373
Practice Address - Country:US
Practice Address - Phone:770-475-4434
Practice Address - Fax:770-475-7756
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA102791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA100362Medicaid
GA9179575Medicaid