Individual
CHANSEOP PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
6516 M D ANDERSON BLVD RM 422, HOUSTON, TX 77030-3402
(713) 500-4267
(713) 500-4353
Mailing address
6516 M D ANDERSON BLVD RM 422, HOUSTON, TX 77030-3402
(713) 500-4267
(713) 500-4353
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
DE60013033
WA
Other
Enumeration date
02/25/2009
Last updated
02/25/2009
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