Organization
JUN PARK D.D.S.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUN Y PARK D.D.S. (HEAD DENTIST)
(410) 321-6120
Entity
Organization
Contact information
Practice address
1205 YORK RD, SUITE 25A, LUTHERVILLE, MD 21093-6210
(410) 321-6120
(410) 321-6121
Mailing address
1205 YORK RD, SUITE 25A, LUTHERVILLE, MD 21093-6210
(410) 321-6120
(410) 321-6121
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13401
MD
1223G0001X
General Practice Dentistry
15632
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548443831
—
MD
Enumeration date
06/25/2015
Last updated
06/25/2015
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