Individual
DR. NAM PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
140 W 69TH ST OFC G1, NEW YORK, NY 10023-5321
(212) 466-6984
Mailing address
140 W 69TH ST OFC G1, NEW YORK, NY 10023-5321
(212) 466-6984
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
053029
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
22DI02506200
NJ
Other
Enumeration date
12/01/2008
Last updated
12/30/2020
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