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General NPI Number Information
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NPI Number | 1043415201
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Entity Type | Individual
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Provider Name | JOUNG PARK DMD
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Gender | Male
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 301 OXFORD VALLEY RD STE 201B
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City | YARDLEY
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State | PA
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Zip | 19067-7708
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Country | US
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Telephone | 215-493-5347
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Fax | 215-493-1176
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Provider Business Mailing Address
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Address Line | 403 SANTA ANITA DR
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City | NORTH WALES
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State | PA
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Zip | 19454-4291
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Country | US
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Telephone | 215-901-4934
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS036672
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License Number State | PA
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