Provider Demographics
NPI:1568687762
Name:WILLIAM D PARKS, DDS, INC.
Entity type:Organization
Organization Name:WILLIAM D PARKS, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-586-1127
Mailing Address - Street 1:23521 PASEO DE VALENCIA
Mailing Address - Street 2:#112
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3107
Mailing Address - Country:US
Mailing Address - Phone:949-568-1127
Mailing Address - Fax:949-586-1129
Practice Address - Street 1:23521 PASEO DE VALENCIA
Practice Address - Street 2:#112
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3107
Practice Address - Country:US
Practice Address - Phone:949-568-1127
Practice Address - Fax:949-586-1129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA288801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty