Individual
DR. MICHAEL PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
55 E MOSHOLU PKWY N, BRONX, NY 10467-2625
(718) 652-7370
Mailing address
55 E MOSHOLU PKWY N, BRONX, NY 10467-2625
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
063686
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/24/2022
Last updated
01/17/2024
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