Organization
IAN PARK DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IAN A PARK DDS (OWNER)
(952) 474-8114
Entity
Organization
Contact information
Practice address
17705 HUTCHINS DR, SUITE 209, MINNETONKA, MN 55345-4145
(952) 474-8114
Mailing address
17705 HUTCHINS DR, SUITE 209, MINNETONKA, MN 55345-4145
(952) 474-8114
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9986
MN
Other
Enumeration date
08/08/2007
Last updated
08/08/2007
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