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Individual
SUNGHAE PARK
Active
Individual
SUNGHAE PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
57834
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8970106
—
NJ
Enumeration date
10/12/2005
Last updated
10/31/2016
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