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Organization
MY DENTIST AND ASSOCIATES, P.A.
Active
Organization
MY DENTIST AND ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YONG PARK (PRESIDENT)
(904) 221-8221
Entity
Organization
Contact information
Practice address
12220 ATLANTIC BLVD, SUITE #128, JACKSONVILLE, FL 32225-5822
(904) 221-8221
Mailing address
12220 ATLANTIC BLVD, SUITE #128, JACKSONVILLE, FL 32225-5822
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN13413
FL
Other
Enumeration date
05/21/2007
Last updated
08/22/2020
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