Individual
HEEJIN PARK SOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1401 S 31ST ST, PHILADELPHIA, PA 19146-3506
(215) 925-2400
Mailing address
1401 S 31ST ST, PHILADELPHIA, PA 19146-3506
(215) 925-2400
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH073729
PA
Other
Enumeration date
09/26/2022
Last updated
09/26/2022
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