Organization
JAMIE Y. PARK, D.D.S., LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMIE Y. PARK D.D.S. (DOCTOR)
(847) 299-5990
Entity
Organization
Contact information
Practice address
8622 W GOLF RD, NILES, IL 60714-5600
(847) 299-5990
(847) 299-5998
Mailing address
8622 W GOLF RD, NILES, IL 60714-5600
(847) 299-5990
(847) 299-5998
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9177023
—
IL
Enumeration date
03/17/2008
Last updated
03/17/2008
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