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Individual
DONG JIN PARK
Active
Individual
DONG JIN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
010794
CT
1223G0001X
General Practice Dentistry
Primary
010794
CT
Other
Enumeration date
07/11/2012
Last updated
09/26/2013
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