Individual
DR. GLORIA S. PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2 EXECUTIVE BLVD STE 304, SUFFERN, NY 10901-8219
(845) 357-4100
Mailing address
622 W 168TH ST, NEW YORK, NY 10032-3720
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
063644
NY
1223G0001X
General Practice Dentistry
22DI02868500
NJ
Other
Enumeration date
06/08/2021
Last updated
01/22/2025
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