Individual
JISUNG PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3557 UNION RD, BUFFALO, NY 14225-5123
(716) 651-0099
Mailing address
3557 UNION RD, BUFFALO, NY 14225-5123
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
060540
NY
Other
Enumeration date
04/24/2018
Last updated
08/06/2019
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