Individual
DR. HENRY INSUK PARK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7611 LITTLE RIVER TPKE, SUITE 106W, ANNANDALE, VA 22003-2602
(703) 750-0110
(703) 750-1211
Mailing address
7611 LITTLE RIVER TPKE, SUITE 106W, ANNANDALE, VA 22003-2602
(703) 750-0110
(703) 750-1211
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401410785
VA
1223G0001X
General Practice Dentistry
049343-1
NY
1223G0001X
General Practice Dentistry
13147
MD
Other
Enumeration date
02/15/2006
Last updated
07/08/2007
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