Organization
PARK PEDIATRIC DENTISTRY OF WOODSTOCK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIUS PARK DMD (CEO)
(770) 926-9260
Entity
Organization
Contact information
Practice address
1816 EAGLE DR, SUITE 200-C, WOODSTOCK, GA 30189-8272
(770) 926-9260
(770) 926-9263
Mailing address
1816 EAGLE DR, SUITE 200-C, WOODSTOCK, GA 30189-8272
(770) 926-9260
(770) 926-9263
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN013851
GA
Other
Enumeration date
10/24/2010
Last updated
10/24/2010
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