Individual
DR. CHARLIE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 COMMERCE DR, SUITE 108, FT WASHINGTON, PA 19034-2714
(267) 460-4254
Mailing address
401 COMMERCE DR, SUITE 108, FT WASHINGTON, PA 19034-2714
(267) 460-4254
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS038502
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2008
Last updated
03/05/2012
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