Individual
DR. KONY PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
4913 MORELAND DR STE 103, GEORGETOWN, TX 78633-5509
(512) 275-4222
Mailing address
30102 DIAMOND DOVE TRL, GEORGETOWN, TX 78628-3724
(253) 503-9655
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
36695
TX
Other
Enumeration date
10/29/2012
Last updated
01/16/2024
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