Organization
MINH DAU, DDS AND RAYMOND PARK, DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND PARK (GOVERNOR)
(425) 284-9886
Entity
Organization
Contact information
Practice address
3105 ALDERWOOD MALL BLVD, SUITE 117, LYNNWOOD, WA 98036-4703
(425) 284-9886
Mailing address
3105 ALDERWOOD MALL BLVD, SUITE 117, LYNNWOOD, WA 98036-4703
(425) 284-9886
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DE60467195
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548521248
—
WA
05
—
1861743205
—
WA
Enumeration date
04/20/2017
Last updated
04/20/2017
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