Park, Ian Anthony

Park, Ian Anthony is an individual health care provider with primary practice located at 17705 Hutchins Dr Suite 209, Minnetonka MN 55345-4145. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Park, Ian Anthony can be contacted via phone (925) 474-8114.

Contact Information

Primary practice address
17705 Hutchins Dr Suite 209 Minnetonka MN 55345-4145
Phone: (925) 474-8114
Fax: (952) 474-5195
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 9986 Minnesota

Profile Details

NPI number 1861494791
LBN Legal business name Park, Ian Anthony
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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