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General NPI Number Information
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NPI Number | 1225690753
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Entity Type | Individual
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Provider Name | JUN HEE PARK DDS
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Gender | Male
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Dates
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Enumeration Date | 07/04/2019
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Last Update Date | 04/26/2023
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Provider Practice Location Address
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Address Line | 1450 STATE ST #500
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City | RICHARDSON
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State | TX
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Zip | 75082
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Country | US
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Telephone | 972-587-0454
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Fax |
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Provider Business Mailing Address
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Address Line | 3065 GALVESTON ST
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City | PLANO
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State | TX
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Zip | 75075-0028
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Country | US
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Telephone | 972-955-2010
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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 | 35358
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License Number State | TX
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