| Anna K Park Dmd Llc | |
|
621 Mullica Hill Rd Richwood NJ 08074 | |
| (856) 218-1877 | |
| (856) 218-1865 |
| Full Name | Anna K Park Dmd Llc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 621 Mullica Hill Rd, Richwood, New Jersey |
| Authorized Official Name and Position | Anna K Park (OWNER) |
| Authorized Official Contact | 8562181877 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Anna K Park Dmd Llc Po Box 277 621 Mullica Hill Rd Richwood NJ 08074 Ph: (856) 218-1877 | Anna K Park Dmd Llc 621 Mullica Hill Rd Richwood NJ 08074 Ph: (856) 218-1877 |
| NPI Number | 1376650093 |
|---|---|
| Provider Enumeration Date | 08/25/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376650093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS030602L (Pennsylvania) | Primary |
| 1223E0200X | Dentist - Endodontics | 22DI02127000 (New Jersey) | Primary |