Individual
JOSHUA JAEYOON PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1010 MAIN AVE, TILLAMOOK, OR 97141-3818
(503) 842-7788
Mailing address
26086 LUGO DR, LOMA LINDA, CA 92354-6507
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11897
OR
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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