Individual
KI DON PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6395 S MCCARRAN BLVD STE B, RENO, NV 89509-6101
(775) 823-9419
Mailing address
2060 EXPERIENCE AVE UNIT 537, RENO, NV 89502-1397
(213) 500-0135
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8090
NV
Other
Enumeration date
07/31/2024
Last updated
07/31/2024
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