Individual
DR. JAKE SANGCHUL PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1 KNEELAND ST, TUFTS DENTAL. DEPARTMENT OF PERIODONTOLOGY, BOSTON, MA 02111
(617) 292-4366
Mailing address
1 KNEELAND ST, TUFTS DENTAL. DEPARTMENT OF PERIODONTOLOGY, BOSTON, MA 02111-1527
(617) 292-4366
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN1855799
MA
Other
Enumeration date
07/27/2011
Last updated
08/07/2018
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