Individual
DR. HOSAN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
25610 104TH AVE SE, KENT, WA 98030-7610
(253) 850-9777
Mailing address
2144 9TH AVE W, SEATTLE, WA 98119-2843
(917) 226-7669
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
019.031420
IL
1223P0300X
Periodontics
Primary
DE60722033
WA
Other
Enumeration date
01/30/2017
Last updated
04/14/2018
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