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Individual

DR. PHILIP DUHEUNG PARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
725 KAPIOLANI BLVD, SUITE C-305, HONOLULU, HI 96813-6012
(808) 593-0078
Mailing address
725 KAPIOLANI BLVD, SUITE C-305, HONOLULU, HI 96813-6012
(808) 593-0078

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DT-1717
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
071378-01
HI
01
1717
HDS
HI
01
821913
TRI CARE
HI
01
A9282-3
HMSA
HI
Enumeration date
12/28/2005
Last updated
07/08/2007
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