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Organization
PAINESVILLE OH DENTIST LLC
Active
Organization
PAINESVILLE OH DENTIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID PARK DMD (CEO/PRESIDENT)
(443) 759-0910
Entity
Organization
Contact information
Practice address
2183 MENTOR AVE, PAINESVILLE, OH 44077-1323
(651) 444-9644
Mailing address
2183 MENTOR AVE, PAINESVILLE, OH 44077-1323
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
08/03/2026
Last updated
08/03/2026
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