Individual
DR. SUSAN MEKYUNG PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
363 SE 4TH AVE, HILLSBORO, OR 97123-4281
(503) 640-1313
Mailing address
1255 NW 9TH AVE APT 803, PORTLAND, OR 97209-2896
(503) 320-7288
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
D8866
OR
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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