Individual
DR. DAVID A PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., D.D.S.
Contact information
Practice address
3610 N UNIVERSITY AVE, SUITE 150, PROVO, UT 84604-4437
(801) 356-2226
(801) 812-1734
Mailing address
3610 N UNIVERSITY AVE, SUITE 150, PROVO, UT 84604-4437
(801) 356-2226
(801) 812-1734
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5129759
UT
Other
Enumeration date
04/06/2007
Last updated
07/28/2008
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