Provider Demographics
NPI:1568278745
Name:PARROTT, PHYLLIS BETH (RDH, BS)
Entity type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:BETH
Last Name:PARROTT
Suffix:
Gender:F
Credentials:RDH, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1719 RAMADA DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-6013
Mailing Address - Country:US
Mailing Address - Phone:281-635-7271
Mailing Address - Fax:
Practice Address - Street 1:106 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:DRESDEN
Practice Address - State:TN
Practice Address - Zip Code:38225-1141
Practice Address - Country:US
Practice Address - Phone:731-364-2913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN941124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist