Organization
JUWON PARK DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN JUWON PARK DMD (PRESIDENT)
(347) 408-8673
Entity
Organization
Contact information
Practice address
4 EXECUTIVE PARK DR, ALBANY, NY 12203-3718
(347) 408-8673
Mailing address
255 PATROON CREEK BLVD APT 1405, ALBANY, NY 12206-5019
(347) 408-8673
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
056491
NY
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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