Individual
RYAN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1138 RIVER ST, HYDE PARK, MA 02136-2970
(617) 361-5020
Mailing address
37 STRATFORD ST, WEST ROXBURY, MA 02132-2008
(857) 210-6333
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1588235196
MA
Other
Enumeration date
07/06/2021
Last updated
06/11/2022
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