Organization
PARK SMILE DESIGN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANG PARK DDS (OWNER)
(312) 332-1450
Entity
Organization
Contact information
Practice address
300 W ADAMS ST STE 323, CHICAGO, IL 60606-5107
(312) 332-1450
Mailing address
300 W ADAMS ST STE 323, CHICAGO, IL 60606-5107
(312) 332-1450
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
019025040
IL
Other
Enumeration date
02/23/2012
Last updated
02/23/2012
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