Individual
DR. JAE HYUN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, PHD
Contact information
Practice address
3155 W INDIAN SCHOOL RD, WESTERN DENTAL ORTHODONTIC OFFICE, PHOENIX, AZ 85017-4035
(480) 286-0455
Mailing address
5519 E BERYL AVE, PARADISE VALLEY, AZ 85253-1165
(480) 286-0455
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7019
AZ
Other
Enumeration date
12/01/2006
Last updated
07/08/2007
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