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Individual
DR. JUN SUP PARK
Active
Individual
DR. JUN SUP PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
107810
CA
122300000X
Dentist
2901022211
MI
Other
Enumeration date
04/27/2017
Last updated
08/19/2022
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