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Organization
COLUMBUS PARK OH DENTIST LLC
Active
Organization
COLUMBUS PARK OH DENTIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID PARK DMD (CEO/PRESIDENT)
(443) 759-0910
Entity
Organization
Contact information
Practice address
4401 CLEVELAND AVE, COLUMBUS, OH 43224-1577
(651) 444-9644
Mailing address
125 LITTLE CANADA RD W STE 200, LITTLE CANADA, MN 55117-1446
(651) 444-9644
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/15/2026
Last updated
09/15/2026
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