Individual
DR. SUSAN MA PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1600 148TH AVE SE, BELLEVUE, WA 98007-6852
(425) 747-3080
Mailing address
9444 SE 52ND ST, MERCER ISLAND, WA 98040-4724
(206) 883-6720
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE7538
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE7538
WA STATE
WA
Enumeration date
09/10/2007
Last updated
09/10/2007
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