Individual
JOON-JAE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
S63W13660 JANESVILLE RD, MUSKEGO, WI 53150-2713
(262) 720-4669
Mailing address
515 S GRANDVIEW BLVD, WAUKESHA, WI 53188-4792
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1001390-15
WI
Other
Enumeration date
04/27/2016
Last updated
07/16/2016
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