| Park Dental Group - Tupelo Pllc | |
|
3999 N Gloster St Ste D Tupelo MS 38804-0950 | |
| (662) 778-2002 | |
| Not Available |
| Full Name | Park Dental Group - Tupelo Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3999 N Gloster St Ste D, Tupelo, Mississippi |
| Authorized Official Name and Position | Young Chan Park (OWNER) |
| Authorized Official Contact | 6627782002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Dental Group - Tupelo Pllc Po Box 70887 Cleveland OH 44190-0887 Ph: () - | Park Dental Group - Tupelo Pllc 3999 N Gloster St Ste D Tupelo MS 38804-0950 Ph: (662) 778-2002 |
| NPI Number | 1528722709 |
|---|---|
| Provider Enumeration Date | 10/25/2021 |
| Last Update Date | 06/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528722709 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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