Individual
DR. YOUNG BAE PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11120 EVERGREEN WAY, #G, EVERETT, WA 98204-3888
(425) 265-1188
Mailing address
11120 EVERGREEN WAY, #G, EVERETT, WA 98204-3888
(425) 265-1188
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE7465
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33-1093673
—
WA
Enumeration date
02/23/2007
Last updated
06/18/2013
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