Organization
JOY DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JI PARK DDS (DENTIST)
(718) 786-2631
Entity
Organization
Contact information
Practice address
2537 BROADWAY, ASTORIA, NY 11106-3413
(718) 786-2631
(718) 956-8425
Mailing address
2537 BROADWAY, ASTORIA, NY 11106-3413
(718) 786-2631
(718) 956-8425
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
054533
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03142927
—
NY
Enumeration date
07/14/2012
Last updated
07/14/2012
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