Provider Demographics
NPI:1538892757
Name:PARRY, CALEB (DMD)
Entity type:Individual
Prefix:DR
First Name:CALEB
Middle Name:
Last Name:PARRY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 REGAL CT
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-4030
Mailing Address - Country:US
Mailing Address - Phone:951-255-8500
Mailing Address - Fax:
Practice Address - Street 1:41258 MARGARITA RD
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5554
Practice Address - Country:US
Practice Address - Phone:951-707-4378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-06
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1075721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice