Individual
DR. SIMON PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
7584 E STATE ROUTE 69, PRESCOTT VALLEY, AZ 86314-2278
(928) 499-3061
Mailing address
G3538 MILLER RD STE A, FLINT, MI 48507-1271
(810) 424-0400
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901600308
MI
Other
Enumeration date
09/09/2019
Last updated
08/24/2022
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