| Juwon Park Dmd Pc | |
|
4 Executive Park Dr Albany NY 12203-3718 | |
| (347) 408-8673 | |
| Not Available |
| Full Name | Juwon Park Dmd Pc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 4 Executive Park Dr, Albany, New York |
| Authorized Official Name and Position | John Juwon Park (PRESIDENT) |
| Authorized Official Contact | 3474088673 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Juwon Park Dmd Pc 255 Patroon Creek Blvd Apt 1405 Albany NY 12206-5019 Ph: (347) 408-8673 | Juwon Park Dmd Pc 4 Executive Park Dr Albany NY 12203-3718 Ph: (347) 408-8673 |
| NPI Number | 1578045258 |
|---|---|
| Provider Enumeration Date | 08/30/2018 |
| Last Update Date | 08/30/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578045258 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 056491 (New York) | Primary |
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