Individual
DR. JAE HOUNG PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8380 W CHEYENNE AVE STE 102, LAS VEGAS, NV 89129-2175
(360) 536-7522
Mailing address
322 ROBLEDO ST, LAS VEGAS, NV 89138-6400
(781) 325-5785
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8083
NV
Other
Enumeration date
06/27/2024
Last updated
11/26/2024
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