Organization
JOHN J PARK LLC
Active
Parent organization
JOHN J PARK LLC
Other names
NE Portland Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
JOHN J PARK LLC
Authorized official
JOHN JOONTAE PARK DDS (DENTIST, OWNER)
(503) 348-3207
Entity
Organization
Contact information
Practice address
2100 NE BROADWAY ST, PORTLAND, OR 97232
(503) 284-2893
(503) 287-2016
Mailing address
12421 SE VOYAGEURS LP, HAPPY VALLEY, OR 97086
(503) 348-3207
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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