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Individual

SOHYUN STEPHANIE PARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
627 FREMONT AVE, SOUTH PASADENA, CA 91030-2527
(626) 799-6255
Mailing address
11311 LA GRANGE AVE APT 327, LOS ANGELES, CA 90025-6868
(225) 439-3940

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DN1857026
MA
1223P0700X
Prosthodontics
102415
CA
1223P0700X
Prosthodontics
Primary
30.027371
OH

Other

Enumeration date
08/18/2015
Last updated
04/04/2024
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