Provider Demographics
NPI:1295822476
Name:PARRIS, NOEL FRANCIS (DDS)
Entity type:Individual
Prefix:
First Name:NOEL
Middle Name:FRANCIS
Last Name:PARRIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 BAKER RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2134
Mailing Address - Country:US
Mailing Address - Phone:678-854-0169
Mailing Address - Fax:678-854-0174
Practice Address - Street 1:20 BAKER RD
Practice Address - Street 2:SUITE 6
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2134
Practice Address - Country:US
Practice Address - Phone:678-854-0169
Practice Address - Fax:678-854-0174
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316821223G0001X
GADN012880122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00304265Medicaid