Park, Kwonil

Park, Kwonil is an sole proprietor health care provider with primary practice located at 1017 E Trinity Mills Rd Suite 102, Carrollton TX 75006-1438. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / General Practice is his primary health care specialty. Park, Kwonil can be contacted via phone (972) 446-7733.

Contact Information

Primary practice address
1017 E Trinity Mills Rd Suite 102 Carrollton TX 75006-1438
Phone: (972) 446-7733
Fax: (972) 446-0088
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 019026108 Illinois
Dental Providers / General Practice 1223G0001X 25071 Texas

Profile Details

NPI number 1740306414
LBN Legal business name Park, Kwonil
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 22nd, 2007
Last updated Jan 11th, 2011 - about 13 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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Identifiers

StateTypeNumberIssuer
All States NPI 1740306414 NPPES
Illinois MEDICAID 1005790
Illinois MEDICAID 207002108

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