| Doctor Name: | MR. DANIEL I PARK |
| NPI Number: | 1598882029 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.D |
| License Number: | DN000312 |
| Business Practice Address: | 30816 Pacific Hwy S Federal Way, WA - 980034902 |
| Business Phone Number: | 2538350055 |
| Business Fax Number: | 2538350055 |
| Mailing Address: | 32704 7th Ave Sw, FEDERAL WAY |
| State: | WA |
| Postal Code: | 980235235 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/22/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 122400000X |
| License Number: | DN000312 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Denturist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |