Individual
DR. JENNA J PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
7701 E BROADWAY BLVD, TUCSON, AZ 85710-3941
(520) 917-2045
Mailing address
20707 N 67TH AVE APT 229, GLENDALE, AZ 85308-6696
(520) 409-2743
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D011095
AZ
Other
Enumeration date
07/08/2021
Last updated
07/08/2021
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