Individual
EUGENE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1159 ULSTER AVE, KINGSTON, NY 12401-1513
(845) 336-0500
Mailing address
150 MYRTLE AVE APT 605, BROOKLYN, NY 11201-2911
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
062038
NY
Other
Enumeration date
05/26/2020
Last updated
06/26/2024
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