Ethelyn Jean Pak

NPI #1083168538 in Smyrna, Tennessee

Provider Information

NPI Number: 1083168538
Entity Type: Individual
Name: Ethelyn Jean Pak
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Enumeration Date: Aug 12, 2016
Last Updated: Aug 17, 2016

Practice Location

Address: 440 SAM RIDLEY PKWY W
City: Smyrna
State: Tennessee
ZIP Code: 37167-2998
Phone: (615) 625-2955

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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