Individual
DR. CHIN S PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2415 W PARK PLACE BLVD, STONE MOUNTAIN, GA 30087-3566
(770) 879-1200
(770) 413-1821
Mailing address
2415 W PARK PLACE BLVD, STONE MOUNTAIN, GA 30087-3566
(770) 879-1200
(770) 413-1821
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN014213
GA
1223G0001X
General Practice Dentistry
Primary
FP2954899
GA
Other
Enumeration date
02/16/2012
Last updated
09/09/2024
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