Individual provider · Type 1 NPI
Eric Park, D.M.D
Orthodontics and Dentofacial Orthopedics Dentistry · Douglasville, GA
Practice location
4935 Stewart Mill Rd, Suite 200
Douglasville, GA 30135-6733
Fax (770) 627-3243
Mailing address
97 Eagle Rock Dr
Acworth, GA 30101-1916
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry Primary | 1223X0400X | 012946 (GA) |
Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…
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About NPI 1144452830
Eric Park, D.M.D's National Provider Identifier is 1144452830, issued on Aug 14, 2009. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Douglasville, GA. The record was last updated on Nov 5, 2010.