Individual
CHAD C PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
815 E BERRY ST # B, FT WORTH, TX 76110-4414
(817) 920-5919
Mailing address
6300 WEST LOOP S STE 650, BELLAIRE, TX 77401-2997
(713) 663-7960
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18645
TX
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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