Individual
DR. IAN ANTHONY PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
17705 HUTCHINS DR, SUITE 209, MINNETONKA, MN 55345-4145
(925) 474-8114
(952) 474-5195
Mailing address
17705 HUTCHINS DR, SUITE 209, MINNETONKA, MN 55345-4145
(925) 474-8114
(952) 474-5195
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9986
MN
Other
Enumeration date
08/11/2005
Last updated
07/08/2007
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