Individual
DR. ERIC PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
4935 STEWART MILL RD, SUITE 200, DOUGLASVILLE, GA 30135-6733
(770) 627-3042
(770) 627-3243
Mailing address
97 EAGLE ROCK DR, ACWORTH, GA 30101-1916
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
012946
GA
Other
Enumeration date
08/14/2009
Last updated
11/05/2010
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