Individual
HYUN W PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
256 N HAMMOND DR, MONROE, GA 30655-2475
(770) 207-0008
(770) 207-0033
Mailing address
256 N HAMMOND DR, MONROE, GA 30655-2475
(770) 207-0008
(770) 207-0033
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN12810
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
858480563A
—
GA
05
—
858480563B
—
GA
05
—
858480563C
—
GA
Enumeration date
11/03/2006
Last updated
01/25/2012
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