Individual
DR. DIANA PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
877 EASTWIND DR, WESTERVILLE, OH 43081-3309
(614) 794-4000
Mailing address
877 EASTWIND DR, WESTERVILLE, OH 43081-3309
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30024229
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0129077
—
OH
Enumeration date
05/06/2014
Last updated
02/24/2016
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