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General NPI Number Information
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NPI Number | 1043452923
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Entity Type | Organization
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Legal Business Name | DAVE C PAK DMD MD PA
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Dates
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Enumeration Date | 03/24/2009
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Last Update Date | 08/05/2009
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Provider Practice Location Address
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Address Line | 123 WASHINGTON ST
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City | ROCHESTER
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State | NH
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Zip | 03839-5505
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Country | US
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Telephone | 603-332-0818
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Fax | 603-332-1204
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Provider Business Mailing Address
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Address Line | 123 WASHINGTON ST
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City | ROCHESTER
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State | NH
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Zip | 03839-5505
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Country | US
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Telephone | 603-332-0818
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Fax | 603-332-1204
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. DAVE C PAK
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Credential | DMD MD
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Telephone | 603-332-0818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number | 03699
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License Number State | NH
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