Organization
PARK DENTAL GROUP, INC
Active
Other names
Park Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JAE SUNG ROH DDS (OWNER)
(815) 267-7878
Entity
Organization
Contact information
Practice address
24047 W LOCKPORT ST, SUITE 207, PLAINFIELD, IL 60544-2205
(815) 267-7878
Mailing address
716 69TH ST, WILLOWBROOK, IL 60527-5353
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
01019026140
IL
Other
Enumeration date
02/19/2010
Last updated
03/05/2024
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