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DR. JIHYUN PARK DMD

>> Dentist >> Dental Providers

Registrant NPI Number: 1144332461

Individual Registrant:
DR. JIHYUN  PARK DMD
Gender: F
Not Sole Proprietor

Location and contact information for practice:
469 HAWKINS AVE  LAKE RONKOKOMA, NY 11779 US
Tel: 631-588-8280  Fax: 631-588-1503

Contact information for business:
139 RIVENDELL COURT  MELVILLE, NY 11747 US
Tel: 631-427-2584  Fax: --

Registration Information:
NPI: 1144332461
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
NY0517461

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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