Provider Demographics
NPI:1386783959
Name:PARKES, PHILIP DANIEL (DDS)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:DANIEL
Last Name:PARKES
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 1:5102 W GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-2327
Mailing Address - Country:US
Mailing Address - Phone:315-468-1843
Mailing Address - Fax:315-468-0632
Practice Address - Street 1:5102 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-2327
Practice Address - Country:US
Practice Address - Phone:315-468-1843
Practice Address - Fax:315-468-0632
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0408331223G0001X
WI41520151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice