| Jun Park D.d.s.,p.a. | |
|
1205 York Rd Suite 25a Lutherville MD 21093-6210 | |
| (410) 321-6120 | |
| (410) 321-6121 |
| Full Name | Jun Park D.d.s.,p.a. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1205 York Rd, Lutherville, Maryland |
| Authorized Official Name and Position | Jun Y Park (HEAD DENTIST) |
| Authorized Official Contact | 4103216120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jun Park D.d.s.,p.a. 1205 York Rd Suite 25a Lutherville MD 21093-6210 Ph: (410) 321-6120 | Jun Park D.d.s.,p.a. 1205 York Rd Suite 25a Lutherville MD 21093-6210 Ph: (410) 321-6120 |
| NPI Number | 1609258722 |
|---|---|
| Provider Enumeration Date | 06/25/2015 |
| Last Update Date | 06/25/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609258722 | NPI | - | NPPES |
| 1548443831 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 13401 (Maryland) | Primary |
| 1223G0001X | Dentist - General Practice | 15632 (Maryland) | Secondary |
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