Individual
JOOYEON PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1207 CHESTNUT ST FL 4, PHILADELPHIA, PA 19107-4131
(215) 525-3046
(215) 309-1133
Mailing address
1233 LOCUST ST FL 3, PHILADELPHIA, PA 19107-5400
(215) 780-1809
(215) 309-1129
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS043036
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104059920
—
PA
Enumeration date
06/29/2020
Last updated
03/29/2023
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