Individual
DR. MICHAEL ALLEN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
541 MAIN ST, LONGMONT, CO 80501-5536
(303) 776-3030
(303) 776-0312
Mailing address
541 MAIN ST, LONGMONT, CO 80501-5536
(303) 776-3030
(303) 776-0312
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8204
CO
Other
Enumeration date
12/04/2006
Last updated
07/08/2007
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