Individual
JOHN SIR PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
43170 SOUTHERN WALK PLZ STE 116, BROADLANDS, VA 20148-4464
(703) 687-4320
Mailing address
43170 SOUTHERN WALK PLZ STE 116, BROADLANDS, VA 20148-4464
(703) 687-4320
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401414285
VA
122300000X
Dentist
Primary
18488
FL
Other
Enumeration date
08/12/2008
Last updated
03/23/2026
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