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Samuel Park, DMD
Student in an Organized Health Care Education/Training Program in Hampton, Virginia
NPI 1609448646

Samuel Park is a Student in an Organized Health Care Education/Training Program based in Fairfax, VA. Samuel Park practices in Hampton, VA and has the professional credentials of DMD. The NPI Number for Samuel Park is 1609448646 and holds a License No. (Virginia).

The current practice location address for Samuel Park is 76 Nealy Blvd Bldg 92, Hampton, VA and can be reached out via phone at 757-225-7630.

Location: 76 Nealy Blvd Bldg 92, Hampton, VA, 22030-7239
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1609448646
Provider Name
Samuel Park
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
76 Nealy Blvd Bldg 92, Hampton, VA, 22030-7239
Phone Number
757-225-7630
Fax Number
Provider Enumeration Date
07/10/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
76 Nealy Blvd Bldg 92
City
Hampton
State
Virginia
Zip
23665-2022
Phone Number
757-225-7630
Fax Number
person
Provider Business Mailing Address Details
Address
76 Nealy Blvd Bldg 92
City
Hampton
State
Virginia
Zip
23665-2022
Phone Number
757-225-7630
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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