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Individual
DR. EARL P PARK
Active
Individual
DR. EARL P PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD MD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
RESTRICTED
LA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
35601
AL
Other
Enumeration date
07/11/2011
Last updated
07/21/2022
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