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Individual

DR. TAE-HOON PARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1300 N ELLINGTON PKWY, LEWISBURG, TN 37091-2218
(931) 359-2825
Mailing address
1300 N ELLINGTON PKWY, LEWISBURG, TN 37091-2218
(931) 359-2825

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11619
TN
1223G0001X
General Practice Dentistry
123971
AK
1223G0001X
General Practice Dentistry
56079
CA

Other

Enumeration date
08/22/2007
Last updated
12/07/2024
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