Individual
JAY PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1404 LAKE TAPPS PKWY SE STE A103, AUBURN, WA 98092-8156
(253) 341-4973
Mailing address
12319 41ST STREET CT E, EDGEWOOD, WA 98372-7801
(931) 494-6959
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE61164036
WA
Other
Enumeration date
05/18/2021
Last updated
05/18/2021
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