Individual
JAE HONG PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1400 PELHAM PKWY S, BRONX, NY 10461-1138
(214) 228-7043
Mailing address
1400 PELHAM PKWY S BLDG 1, BRONX, NY 10461-1119
(347) 509-4084
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
061100
NY
Other
Enumeration date
02/14/2018
Last updated
09/05/2023
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