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Organization
ADVANCED ORAL REHABILITAION
Active
Organization
ADVANCED ORAL REHABILITAION
Active
Other names
Branford Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WOO IL STEVEN PARK DDS (DENTIST)
(973) 424-0040
Entity
Organization
Contact information
Practice address
23 BRANFORD PLACE, NEWARK NJ, NJ 07105
(973) 424-0040
(973) 424-0089
Mailing address
23 BRANFORD PLACE, NEWARK NJ, NJ 07105
(973) 424-0040
(973) 424-0089
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02324700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0252727
—
NJ
Enumeration date
05/16/2012
Last updated
05/16/2012
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