Organization
ADVANCED ORAL REHABILITAION
Active
Other names
Branford Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WOO IL STEVEN PARK DDS (DENTIST)
(973) 424-0040
Entity
Organization
Contact information
Practice address
23 BRANFORD PLACE, NEWARK NJ, NJ 07105
(973) 424-0040
(973) 424-0089
Mailing address
23 BRANFORD PLACE, NEWARK NJ, NJ 07105
(973) 424-0040
(973) 424-0089
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02324700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0252727
—
NJ
Enumeration date
05/16/2012
Last updated
05/16/2012
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