Individual
DR. JAMES PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
359 S WASHINGTON AVE, BERGENFIELD, NJ 07621-4311
(201) 385-2500
Mailing address
359 S WASHINGTON AVE, BERGENFIELD, NJ 07621-4311
(201) 385-2500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
050126-1
NY
1223G0001X
General Practice Dentistry
13122
MD
1223G0001X
General Practice Dentistry
Primary
22DI02194700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02779124
—
NY
Enumeration date
01/18/2007
Last updated
11/23/2015
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