Organization
JASTHI-PARK & ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUN Y PARK DDS (OWNER)
(410) 781-7188
Entity
Organization
Contact information
Practice address
2030 LIBERTY RD, ELDERSBURG, MD 21784-6129
(410) 781-7188
(410) 781-0269
Mailing address
2030 LIBERTY RD, ELDERSBURG, MD 21784-6129
(410) 781-7188
(410) 781-0269
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13401
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407039423
INDIVIDUAL NPI
MD
01
—
1548443831
INDIVIDUAL NPI
MD
01
—
1619952710
INDIVIDUAL NPI
MD
Enumeration date
02/18/2010
Last updated
02/18/2010
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