Organization
PARK DENTAL GROUP - TUPELO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOUNG CHAN PARK (OWNER)
(662) 778-2002
Entity
Organization
Contact information
Practice address
3999 N GLOSTER ST STE D, TUPELO, MS 38804-0950
(662) 778-2002
Mailing address
PO BOX 70887, CLEVELAND, OH 44190-0887
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/25/2021
Last updated
06/21/2023
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