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Individual

DR. JACOB GYEONGIL PARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
7434 LOUIS PASTEUR DR, SUITE 303, SAN ANTONIO, TX 78229-4538
(210) 615-7224
(210) 615-7229
Mailing address
7434 LOUIS PASTEUR DR, SUITE 303, SAN ANTONIO, TX 78229-4538
(210) 615-7224
(210) 615-7229

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17106
TX

Other

Enumeration date
04/11/2007
Last updated
07/08/2007
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