| Sun Park Dds Pc | |
|
102 Elden St Ste 17 Herndon VA 20170-4827 | |
| (703) 485-9098 | |
| (703) 485-8098 |
| Full Name | Sun Park Dds Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 102 Elden St Ste 17, Herndon, Virginia |
| Authorized Official Name and Position | Sun Park (PRESIDENT) |
| Authorized Official Contact | 5714859098 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sun Park Dds Pc 102 Elden St Ste 17 Herndon VA 20170-4827 Ph: (703) 485-9098 | Sun Park Dds Pc 102 Elden St Ste 17 Herndon VA 20170-4827 Ph: (703) 485-9098 |
| NPI Number | 1699041897 |
|---|---|
| Provider Enumeration Date | 04/02/2012 |
| Last Update Date | 04/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699041897 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 0401412056 (Virginia) | Primary |
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