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Individual

DR. JULIUS PARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
1816 EAGLE DR, 200-C, WOODSTOCK, GA 30189-8272
(770) 926-9260
(770) 926-9263
Mailing address
1816 EAGLE DR, 200-C, WOODSTOCK, GA 30189-8272
(770) 926-9260
(770) 926-9263

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
050223
NY
1223P0221X
Pediatric Dentistry
22DI02198100
NJ
1223P0221X
Pediatric Dentistry
Primary
DN013851
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02731033
NY
Enumeration date
02/21/2007
Last updated
09/22/2010
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