Organization
UPPER WEST SIDE ORAL & MAXILLOFACIAL SURGERY
Active
Organization
UPPER WEST SIDE ORAL & MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAM PARK DDS, MD (DDS, MD)
(646) 734-6742
Entity
Organization
Contact information
Practice address
140 W 69TH ST PH 1G, NEW YORK, NY 10023-5173
(646) 734-6742
Mailing address
140 W 69TH ST PH 1G, NEW YORK, NY 10023-5173
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/07/2020
Last updated
08/07/2020
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