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Individual

DR. JAMIE H PARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
10680 MAIN ST, SUITE 150, FAIRFAX, VA 22030-3810
(703) 385-4569
(866) 763-9957
Mailing address
10680 MAIN ST, SUITE 150, FAIRFAX, VA 22030-3810
(703) 385-4569
(866) 763-9957

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401410033
VA

Other

Enumeration date
08/01/2006
Last updated
07/08/2007
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