Provider Demographics
NPI:1548368640
Name:PARISEK, ANTHONY (DDS)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:PARISEK
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 1:301 JEWETT ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-2624
Mailing Address - Country:US
Mailing Address - Phone:507-537-9667
Mailing Address - Fax:
Practice Address - Street 1:301 JEWETT ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-2624
Practice Address - Country:US
Practice Address - Phone:507-537-9667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2013-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51635122300000X
MND13127122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist