Organization
JENNA PARK DMD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE BARBER (PROVIDER ENROLLMENT MANAGER)
(315) 454-6000
Entity
Organization
Contact information
Practice address
6303 E BROADWAY BLVD STE 101, TUCSON, AZ 85710-3547
(520) 276-1654
Mailing address
PO BOX 70887, CLEVELAND, OH 44190-0887
(315) 454-6000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/14/2025
Last updated
07/14/2025
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