Individual
DR. JOSEPH S PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
412 STATE ROUTE 37, HOGANSBURG, NY 13655-3109
(518) 358-3141
(518) 358-2797
Mailing address
412 STATE ROUTE 37, HOGANSBURG, NY 13655-3109
(518) 358-3141
(518) 358-2797
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0511251
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03078080
—
NY
05
—
44007027
—
NM
05
—
852708
—
AZ
05
—
89875818
—
CO
Enumeration date
11/02/2005
Last updated
03/25/2015
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