Individual
ETHELYN JEAN PAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
440 SAM RIDLEY PKWY W, SMYRNA, TN 37167-2998
(615) 625-2955
Mailing address
1518 RED OAK DR., BRENTWOOD, TN 37027
(615) 483-0728
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10295
TN
Other
Enumeration date
08/12/2016
Last updated
08/17/2016
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