Individual
DR. JULIE LEE PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
538 POLARIS PKWY, WESTERVILLE, OH 43082-7044
(614) 682-6213
Mailing address
1110 JAEGER ST, COLUMBUS, OH 43206-2661
(347) 630-1858
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
054729
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
30.024943
OH
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS039263
PA
Other
Enumeration date
03/23/2010
Last updated
02/01/2017
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