MEDICARE: DAVID B PARK DDS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	50051020DDS	NY

General Provider Information

NPI Number	:	1588837330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID B PARK DDS MD

Provider Business Mailing Address
First Line	:	260 MIDDLE COUNTRY RD
Second Line	:	BUILDING 2, SUITE 12
City	:	SELDEN
State	:	NY
Zip	:	11784-2568
Country	:	US
Telephone Number	:	631-696-9752
Fax Number	:	631-696-5096

Provider Business Practice Location Address
First Line	:	260 MIDDLE COUNTRY RD
Second Line	:	BUILDING 2, SUITE 12
City	:	SELDEN
State	:	NY
Zip	:	11784-2568
Country	:	US
Telephone Number	:	631-696-9752
Fax Number	:	631-696-5096

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2008
Last Update Date	:	06/11/2009

Similar Medicare Providers

1831199694 — DR. MARIO JOSEPH CAPUANO DDS
Practice Location Address:

260 MIDDLE COUNTRY RD , BLDG 2 SUITE 12
SELDEN, NY
11784-2568

Practice Phone: 631-696-9752
Practice Fax: 631-696-5096

1699841163 — DR. STEPHEN SCOTTO-LAVINO DDS
Practice Location Address:

260 MIDDLE COUNTRY RD , SUITE 20
SELDEN, NY
11784-2568

Practice Phone: 631-698-9400
Practice Fax: 631-698-3272

1609013465 — MRS. HAYDEE PONDAR OTR/L
Practice Location Address:

260 MIDDLE COUNTRY RD , BLDG 3 SUITE 9 A
SELDEN, NY
11784-2568

Practice Phone: 631-732-1600
Practice Fax:

1477792224 — MS. GERTRUDE REMOROZO CALICA PT
Practice Location Address:

260 MIDDLE COUNTRY RD , # 9A
SELDEN, NY
11784-2568

Practice Phone: 631-732-1600
Practice Fax: 631-732-7872

1871883249 — PHANI JAYA SREE KAZA PT
Practice Location Address:

260 MIDDLE COUNTRY RD , BLDG.3, SUITE 9-A
SELDEN, NY
11784-2568

Practice Phone: 631-732-1600
Practice Fax: 631-732-7872

1689951972 — MR. HAROLD M MONIZ PT
Practice Location Address:

260 MIDDLE COUNTRY RD , BUILDING 3, SUITE 9 -A
SELDEN, NY
11784-2568

Practice Phone: 201-744-4309
Practice Fax:

Directions to “ DAVID B PARK DDS MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.