Individual
DR. KI HONG PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
2441 21ST ST, FORT CAMPBELL, KY 42223
(270) 798-8751
Mailing address
2441 21ST ST, FORT CAMPBELL, KY 42223-5582
(270) 798-8751
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN014638
GA
Other
Enumeration date
01/14/2015
Last updated
07/17/2018
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