Individual provider · NPI-1
Daniel I Park, L.D
Denturist · Federal Way, WA
NPI number1598882029
StatusActive
Last updated in NPPESJul 9, 2007
Details
- NPI
- 1598882029
- Entity type
- Individual (NPI-1)
- Name
- Mr. Daniel I Park
- Credential
- L.D
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 22, 2007
- Last updated
- Jul 9, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122400000X | Denturist | DN000312 | WA | Yes |
Practice location
30816 Pacific Hwy SFederal Way, WA 98003-4902
Phone 253-835-0055 · Fax 253-835-0055
Mailing address
32704 7th Ave SwFederal Way, WA 98023-5235
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